Regional Review of Neurology Services - Page 1 of 7 - NI Direct

Page 1 of 7

Section 1: About you

When completing this section, you only need to answer the questions that are relevant to you.

What is your name?

Name

What is your email address?

First part of postcode

(e.g. BT25)

Are you responding as an individual or on behalf of an organisation?

(Required) Individual (General public) Individual (Service user) Individual (Family / carer) Organisation

If replying as an individual, please indicate if you do not wish for your identity to be made public

Yes No

If you selected organisation, please provide the details of the organisation you represent.

Whilst not essential, it would assist the Department in analysing responses if responding on behalf of an organisation, you could provide details of who your organisation represents and, where applicable, how the views of members were assembled?