Existing members

If you are an existing member of the Trust, you can use this form to update your contact details, change the ways in which we may contact you, opt out of receiving communications relating to your membership (or opt back in to such communications, if you have previously opted out) or cancel your membership.

Your details

To help us identify your member record, please provide the details you gave us when becoming a member (or the latest details we should have on record for you, if you have previously changed these).

First name*

Last name*

Date of birth (DD/MM/YYYY)*

Address line 1*

Address line 2

Town/city*

Country*

Postcode*

Update your contact details

If you would like to change any of the contact details we hold for you, you can do so here by completing the relevant fields. For example if only your address has changed, you do not need to complete the name, telephone number or email address fields.

If there are no changes to your contact details, you may leave this section blank.

New title

New last name

New email address

New telephone number

New address

Change how we contact you

If you would like to change how we contact you, please tick the appropriate box or boxes. Please note that if you tell us you are happy to be contacted by post, telephone or email, this will "opt you in" to such communications again, even if you have previously opted out.

If you don't want to change how we contact you, you may leave this section blank.

Please tell us your communication preferences:

I am happy to be contacted by post
I am happy to be contacted by telephone
I am happy to be contacted by email
Please do not contact me about my membership

End your membership

If you no longer wish to be a member of the Trust, you can end your membership by selecting the option below.

I no longer wish to be a member of University Hospitals Birmingham NHS Foundation Trust.

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