PPI Panel Recruitment Form

Data protection

When you became a member of MDI, you acknowledged that we need to process your personal data. You can read MDI’s Membership Privacy Notice here. 
 
Additionally, as a member of MDI’s PPI Panel, you acknowledge that we will use your data so that you can participate in our PPI process. Where we need to share your data with a third party, we will only do so in instances where we have your prior explicit consent.

Your data will be retained in line with MDI’s Data Retention Schedule.

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* 1. Name

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* 2. What is  your address?

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* 3. Email

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* 4. Telephone

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* 5. Age 

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* 6. Are you affected by a neuromuscular condition?

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* 7. Are you a parent of a child with a neuromuscular condition?

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* 8. Are you a carer for an individual with a neuromuscular condition?

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* 9. Are you interested in any of the research topics listed in the table below?

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* 10. If an area of research that you are interested in has not been listed above, please feel free to add your topic to the comment box below.

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