Foundation Trust Membership Form

Welcome to Surrey and Sussex Healthcare NHS Trust. If you are interested in what we do and how we work, you can register below to become a member of our Trust (Membership Information). You have to be 14 and over to become a member of our Trust. Becoming a member is simple, you can either complete the online foundation trust membership form on this page or download the Membership Form and post it to us.

Fields marked with * are mandatory. 
Member type
Title
First name *
Last name *
Middle name
Date of birth *
Gender
  Please enter your postcode, and click Get Address
Address *
 
 
Town or City
County
Postcode *
Country
Home telephone
Mobile
Email
Twitter
Preferred method of contact 




Ethnic Origin
Religion/Belief
Sexual Orientation