This is a way for patients and NHS & East Clinical Your contact details Sexual Health Disabilities – physical and Smoking and Quitting sensory impairment communities to stay in touch with Commissioning Group Name: Social Care – how Gender (including gender healthcare is linked to reassignment) Address: activities and news and to have a NHS Ipswich & East Suffolk Clinical Commissioning Group (CCG) services Homeless will have responsibility for buying and managing healthcare Postcode: Stroke Learning Disabilities voice on local issues relating to services for everyone who lives in Ipswich & east Suffolk from Tel: Substance Misuse LGB&T – lesbian, gay, All the above bisexual and transgender April 2013. The CCG is led by local GPs and other clinicians, Email: health and healthcare. Other, please state: Marriage and civil meaning for the first time, the management of services ranging If you are joining on behalf of a group or organisation partnership from mental health to hospital services, will be clinically led. please also tell us: Older People Any individual who lives in the Name of group / organisation Pregnancy and maternity The CCG’s vision is: Prisoners / Ex Offenders Ipswich & east Suffolk area or who Name / role of main point of contact Religion and Belief • To work in partnership with the community and clinicians to Communities of interest Rural Communities has a connection to the area (e.g. meet the health needs of the population we serve, while (tick as many as you like) Sex Workers maintaining a grip on finances Geography of interest Diabetes Asylum Seekers / Refugees Other, please state: works here, or is the carer of (tick as many as you like): Domiciliary / Healthcare BME, Black and Ethnic • To help people help themselves and be innovative in our & district at Home Minorities – All someone who lives here) is welcome approach to improving healthcare Eye & district Emergency Care / African & district Ambulance / A&E African Caribbean to join. • To make sure we have strong local providers and a system Ipswich & district End of Life Care Asian which can cope with change & district Family Carers Bangladeshi Is there anything else you Woodbridge & district GPs Chinese would like to tell us about Whole of Ipswich & East Health Inequalities Gypsies and Travellers / Any community group, voluntary What you can expect when you join. your interests in health and Suffolk Healthy Lifestyles / Romany Exercise / Eating Well healthcare that would help organisation or stakeholder which • You will receive regular updates on healthcare, community Indian Health and healthcare Heart / Coronary / us to involve you better? news and issues Iranian has an interest in health and subjects of interest Cardiovascular Kurdish • Occasionally, you may be invited to take part in projects, (tick as many as you like): Hospitals Pakistani Maternity healthcare in the Ipswich & east surveys and meetings that interest you, for example because Cancer Polish Children and Young Mental Health / they are taking place in your area, or because particular health Other, please state: Suffolk area can also join. People Psychological matter is important to you. Participation is always optional Clinical Safety Out of Hours Dementia Patient Experience • It is free to join and you can choose how much you would Dentists / Pharmacies / Rehabilitation / like to be involved It is free to join. Optical Practices Intermediate Care Please tear off to detach Please return your form to: Protecting your data: Points of view, We will ensure your Ipswich and East Suffolk CCG, information is kept securely Rushbrook House, and will only be used for the Paper Mill Lane, purposes stated above. It For more information please contact us by: Bramford, will not be shared with Telephone 01473 770014 Ipswich, IP8 4DE outside organisations or email [email protected] without your consent. Prepaid envelopes are available. If there isn’t a prepaid envelope attached, Thank you for your interest please phone us and we will in health and healthcare in be happy to send you one. Ipswich & east Suffolk! If you would like any part of this document in another format – such as EasyRead, Large print, Braille, Audio – and / or translated into another language, please contact us on 01473 770014

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