Network Survey

* 1. Address of your organsation

* 2. Please let us know the main contact for your organisation

* 3. Brief Description of your organsation

* 4. Please list the types of patient empowerment activities your organisation is involved in

* 5. Please list any specific training or interventions you offer

* 6. are you willing to have your contact details passed on to other interested organisations?

* 7. Would you like to receive news letters/updates from ENOPE

* 8. Please use this space to add any additional information including suggestions on possible future ENOPE activities