Skip to main content
Skip to navigation
Skip to mobile navigation
Skip to accessibility tools
SEL Cancer Alliance Socials
SEL Cancer Alliance Share
Mobile navigation
Search this website
Search
Search
Home
About us
About us
Return to previous menu
About us
What is a Cancer Alliance?
Our partners and networks
Contact Us
Our work
Our work
Return to previous menu
Our work
Prevention and early diagnosis
Prevention and early diagnosis
Return to previous menu
Prevention and early diagnosis
Screening and immunisation
Timely presentation
Primary care
Local innovation
NHS Lung Cancer Screening
NHS Lung Cancer Screening
Return to previous menu
NHS Lung Cancer Screening
About screening
Information for patients
Information for patients
Return to previous menu
Information for patients
Who is eligible for a lung health check
What happens at a lung health check
Frequently asked questions
Tips to keep your lungs healthy
Patient booklet
Patient stories
Information for professionals
Contact us
Faster diagnosis and treatment
Personalised care
Patient experience and involvement
Workforce and education
Innovation
For healthcare professionals
For healthcare professionals
Return to previous menu
For healthcare professionals
Latest guidance and resources
Latest guidance and resources
Return to previous menu
Latest guidance and resources
Screening and earlier diagnosis
Screening and earlier diagnosis
Return to previous menu
Screening and earlier diagnosis
Campaign resources for HCPs
Early cancer diagnosis resource for primary care
Faster diagnosis and Treatment
Cancer and serious mental illness
Personalised care
Supporting cancer care through non-clinical roles
Continuing Professional Development and Events
Cancer Care Map
For patients, carers and public
For patients, carers and public
Return to previous menu
For patients, carers and public
Support our early diagnosis campaigns
Supporting you: personalised care
Supporting you: personalised care
Return to previous menu
Supporting you: personalised care
Health and Wellbeing Information and Support
Health and Wellbeing Information and Support
Return to previous menu
Health and Wellbeing Information and Support
Managing side effects and late effects of your treatment
Managing side effects and late effects of your treatment
Return to previous menu
Managing side effects and late effects of your treatment
Keeping active during treatment
Benefits of cancer rehabilitation
Benefits of Cancer Rehabilitation
Keeping Active during treatment
What can I do to help myself?
Cancer and serious mental illness
Cancer information for people with learning disabilities
Get involved
Get involved
Return to previous menu
Get involved
How to become a patient partner
How to become a patient partner
Return to previous menu
How to become a patient partner
Involvement opportunities
How to become a patient partner
News
How to become a patient partner
Home
For patients, carers and public
Get involved
How to become a patient partner
How to become a patient partner
Back to How to become a patient partner
Are you a patient or a carer?
Required
Patient
Carer
Name
Required
Year of birth
Address
Address 1
Address 2
City
Country
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Canary Islands
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Ceuta & Melilla
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo - Brazzaville
Congo - Kinshasa
Cook Islands
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Diego Garcia
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard & McDonald Islands
Honduras
Hong Kong SAR China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR China
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé & Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St Barthélemy
St Helena
St Kitts & Nevis
St Lucia
St Martin
St Pierre & Miquelon
St Vincent & Grenadines
Sudan
Suriname
Svalbard & Jan Mayen
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad & Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Outlying Islands
US Virgin Islands
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
County
Postal Code
Email address
Required
Contact number
Required
Ethnic group
Required
Asian / Asian British
Black / African / Caribbean / Black British
Mixed / multiple ethnic groups
Other ethnic group
Prefer not to say
White
If you take part in other patient groups or NHS Improvement projects - please give details below
How would you like us to contact you?
Required
E-mail
Phone
Post
How would you like to participate in SELCA projects?
Required
Online (email)
Online (virtual events and meetings)
Phone
In-person
Please let us know if you have any particular areas of interest, professional background skills, or expertise you can further contribute with:
If you are a patient - what type(s) of cancer have you been diagnosed with?
Where did you receive your cancer diagnosis?
Guy's and St Thomas' NHS Foundation Trust
King's College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
Other
Where do / did you receive your cancer treatment?
Guy's and St Thomas' NHS Foundation Trust
King's College London NHS Foundation Trust
Lewisham and Greenwich NHS Trust
Other
Have you used any of the treatment services listed below?
Surgery
Chemotherapy
Radiotherapy
Therapies (physiotherapy, mental health, etc)
Any other comments or things you want to tell us?
I agree to the
privacy policy
.
Submit
Skip past links
You might also be interested in...
Involvement opportunities
Accessibility tools
Show
accessibility tools
Dyslexic font:
Dyslexic font
Text size:
Increase text size
Decrease text size
Reset text size
Contrast:
Black and white
Blue contrast
Beige contrast
High contrast
Reset contrast
Frank Ltd.
Last accessibility toolbar action:
none available
Return to header
