This palliative care research Special Interest Group is one of three pilot groups set up and supported by the All Ireland Institute of Hospice and Palliative Care (AIIHPC). If you would like to join the group, please complete your details below. You can leave the group at any time by emailing info@aiihpc.org

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* 1. Email Address

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* 2. First Name

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* 3. Last name

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* 4. Role:
Please add your role outside of this group which you think is most relevant - e.g. job title, Voices4Care member, or however else you wish to self define

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* 5. Organisation or affiliation:
Relevant organisation(s) or other affiliation e.g. your employer, where you are studying, Voices4Care if you are a member etc. If you do not have an affiliation which you consider relevant, please feel free to put 'N/A'

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* 6. Please confirm that these details can be stored by AIIHPC, and shared with other group members:
In order for you to be a member of the Special Interest Group these details must be stored and used by AIIHPC and group organisers for the purposes of managing the group. Other group members can also see details of those in the same group as them.

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* 7. Please confirm that you give your permission to be contacted by email about the Dementia and Palliative Care Research Special Interest Group:
Email is the main way of sharing information about the group - such as documents, invitations to meetings, events etc. We regret it is not possible to be a member of the group if you prefer not to be contacted by email.

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