HIN Form

HIN Form2018-09-06T10:27:23+00:00

Please join our Health Involvement Network

We want you to help us shape your local NHS services. We want to listen to your views and experiences to help us build better health care services in Dorset. Please fill out the details below to receive our quarterly newsletter and to be informed about opportunities where you can get involved.

If you are already a member:

Why do you need to complete this form?

By completing this form, you are agreeing that you are happy to continue to receive our email newsletter which provides updates on the work of Dorset’s health and care services and opportunities to get involved with our work.

Why we want to know about you?

By telling us a little bit more about yourself we can send you information in our newsletter that is relevant to you and your local area.

Who will have access to your information?

Your information will be held securely and will only be accessed by the NHS Dorset Clinical Commissioning Group (CCG) Engagement and Communications team and authorised staff involved in the projects you have asked to be involved with.

Everyone at the CCG has a responsibility, under Data Protection law, to protect your personal information. We will ensure that it is stored, used, and transferred in accordance with the Act and all other applicable legislation.

Retention of information and unsubscribing

We will hold your details in accordance with the Records Management Code of Practice for Health and Social Care 2016, and the CCG’s Records Retention Policy.

You can unsubscribe from our newsletter at any time by clicking the unsubscribe link in the email we send or by contacting us by email at communications@dorsetccg.nhs.uk or telephone on 01202 541946.

Once you have unsubscribed you will stop receiving our newsletter straight away, but we will continue to hold your details for a short time while we process your request. We will then delete your details from our database.

Data Protection Act – your consent

I agree to allow my personal information to be stored by NHS Dorset Clinical Commissioning Group (CCG), so that I may continue to receive the CCG email newsletter. I understand that Dorset CCG is committed to protecting my privacy and will use my information lawfully, in accordance with the Data Protection legislation, for the purpose set out in this form.

My information will be held securely, will not be shared with other organisations without my consent and will only be accessed by the NHS Dorset CCG Engagement and Communications team and authorised staff involved in the projects you have asked to be involved with.


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