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Ethnic Origin	Not stated White - English, Welsh, Scottish, Northern Irish, British White - Irish White - Gypsy or Irish Traveller White - Other Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - Other Mixed Asian or Asian British - Indian Asian or Asian British - Pakistani Asian or Asian British - Bangladeshi Asian or Asian British - Chinese Asian or Asian British - Other Asian Black or Black British - African Black or Black British - Caribbean Black or Black British - Other Black Other Ethnic Group - Arab Other Ethnic Group - Any Other Ethnic Group

Disabilities	No Yes A sensory disability (please specify) A physical disability (please specify) A learning disability (please specify) A mental health problem (please specify) Any other special need (please specify)
How would you like to be involved?	Armchair consultation – receive emails to give your views on leaflets, policies and other Trust docs Attending focus groups for planning or developing services Improving and/or delivering staff training programmes Attending service user and carer forums to feedback on services Taking part in intensive “Rapid Process Improvement Workshops” to improve quality of services Taking part in the recruitment of new staff Enrol in Wellbeing+Recovery College using your experience of services to develop & deliver training Helping with surveys, audits and/or research projects Hospital / environment inspections Taking part in panels for judging awards for staff and/or service users and carers Involvement representative – enthusiasm for the role, to be a buddy/champion to support our new recr Graphic design work for Trust publications / initiatives / events Writing articles / leaflets / other literature for the Trust Presenting and/or co-chairing at Trust meetings or events Interested in volunteer opportunities with the Trust
Service preferences?	Children's Services Medicines Management and Pharmacy Drug and Alcohol Prison in reach Learning Disabilities Mother and Baby Services Non-Clinical Services Forensic Mental Health Older Adults Mental Health Eating Disorders Substance Misuse Adults of Working Age Mental Health Occupation Therapy Dignity and Respect Early Recognition of People in Need General Interests Other Involve NORTH physical health adult social care Involve SOUTH Mental Health adult Involve NORTH Haywood/ Leek Hospitals Involve SHROPSHIRE Mental Health Adult Involve SHROPSHIRE Children 0-25 Involve SPECIALIST Sexual Health Involve SPECIALIST Forensics Involve SPECIALIST IAPT Involve SPECIALIST Learning Disabilities Involve SPECIALIST Substance Misuse Involve SPECIALIST Physical Health Adult Involve SPECIALIST Eating Disorders Involve SPECIALIST SALT Involve SPECIALIST PAD Involve CHILDREN & FAMILIES S Staffs Involve CHILDREN & FAMILIES Stoke, N Staffs Involve CHILDREN & FAMILIES Mother & Baby Involve SOUTH Physical Health Adult Social Care
How are you connected with the Trust?	Service User Carer Member of the Public Volunteer SSOTP Member
How did you hear about the trust?	Event Through an Employee Website Online Membership Form PALS Other (please specify)

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