Breadcrumb Hafan Request for public involvement Cyfredol Page 1 Page 2 Page 3 Wedi'i gwblhau Request for public involvement support If you would like support to involve members of the public in your project please complete the form below. This will provide us with the basic information we need to work with you to develop an advert to recruit members of the public to be involved in your project. Once we have received the form we will contact you to discuss your requirements. Before you start to complete the form you must read this guidance document. The guidance document will help you complete the form and will tell you what information you will need to provide before you start. Health and Care Research Wales have developed three categories for public involvement opportunities to be used when developing your involvement adverts. Please read our guide to find out more about our public involvement categories. If you need any further support with this please contact the team by email at: research-involvement@wales.nhs.uk. First name Surname Organisation Email address Email address Please confirm your email address Contact phone number Title of the involvement opportunity Is your project linked to the Health and Care Research Wales funded research community? If so, please indicate which you are linked to: - Select -Brain Repair and Intracranial Neurotherapeutics UnitCentre for Ageing & Dementia ResearchCentre for the Development and Evaluation of Complex Interventions for Public Health ImprovementCentre for Trials ResearchChildren's Social Care Research and Development Centre PartnershipDiabetes Research WalesGambling Research, Evaluation and Treatment Wales NetworkHealth and Care Economics Cymru (formerly WHESS)National Centre for Mental HealthNational Centre for Population Health and Wellbeing ResearchNHS R&DNorth Wales Organisation for Randomised Trials in HealthResearch Capacity Building Collaboration (RCBC) WalesSecure Anonymised Information Linkage DatabankSpecialty leadSwansea Trials Unit Wales Cancer Bank Wales Cancer Research Centre Wales Centre for Primary and Emergency Care Research (PRIME)Wales Gene Park Wales School for Social Prescribing ResearchWales Kidney Research Unit Welsh GovernmentOther If other please specify If R&D please specify which one Aneurin Bevan University Health Board Betsi Cadwaladr University Health Board Cardiff and Vale University Health Board Cwm Taf Morgannwg University Health Board Hywel Dda University Health Board Powys Teaching Health Board Public Health Wales Swansea Bay University Health Board Velindre NHS Trust Welsh Ambulance Service NHS Trust