UK Informetis Assisted Living Trial

Expression of Interest

If your are interested in taking part in the trial, please can the designated younger person complete the following information about themselves and their elderly relation or friend. Please will you ensure that you have discussed the trial with your elderly relation or friend and they have given you permission to complete this form on their behalf.

At this stage, you are only expressing interest in taking part in the trial. We will also be sending out separate agreement forms for signing - to both the designated person and their elderly relation or friend before the start of the trial.

However, by completing this online form you will be agreeing that we will hold personal data about the designated younger person and the elderly relation for the purposes of communicating with them and the management of the trial. We will not sell or pass on any of this data to third party organisations without your permission.

If you have any problems filling in the form please contact me on 01353 667973 or email me xpeter.bates@informetis.com 

Compulsory fields are marked with asterisk *

Please note: The information is collected on behalf of Informetis by pjb Associates. Both companies are registered with the Information Commissioner's Office (ICO) under the Data Protection Act 1998 (DPA) The information collected will not be given to any 3rd Party without your permission.