Patient Partner Application Form

Thank you for your interest in becoming a Patient Partner at Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT). Our vision is that your insights will help to identify what really matters most to our patients in their health care experience. Together we will improve quality, safety and the patient experience.

Take a look at our safeguarding leaflets, and complete the  Occupational Health pre placement assessment form docx [docx] 122KB. Download the form and email it to our Occupational Health team.

• Safeguarding Children Leaflet (August 2023) (Staff).pdf [pdf] 259KB
• Safeguarding Adults - Raising Awareness Leaflet (August 2023) (Staff).pdf [pdf] 278KB

Your Details:

Note: Questions marked by * are mandatory

Please refer to the privacy notice on how we use and store your data. 

*This is a mandatory field. Title

Please Select An Option OtherMrMrsMissMs

*This is a mandatory field. First Name

*This is a mandatory field. Last Name

*This is a mandatory field. Address

Phone Number - Home

Phone Number - Mobile

*This is a mandatory field. Email

* Spam Guard: What is 2+2? (Write the number as a word.)