PSPA Online Join Us Form for Health and Social Care Professionals (HSCPs)
Once we have received your form we will send you an introductory email. We aim to communicate mainly by email as this is more cost effective for us.
Contact Details
Salutation
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Dr
Miss
Mr
Mrs
Ms
Professor
First Name
Last Name
Preferred Name (nickname)
Job Title (if not listed, please select 'Other') & state below:
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Other
Activities Coordinator
Admin / Secretary
Admiral Nurse
Adult Services Officer
Advocacy Worker
Agency Carer
Assistant Director
Assistant Support Officer
Associate Specialist in Neurology
Ataxia Nurse Specialist
Auxiliary Nurse
Care Assistant
Care Coordinator
Care Home Manager
Care Home nurse
Care Home staff member
Care Manager
Care Navigator
Care Officer
Carers Assessment
Carers Organisation
Care Supervisor
Care Worker
Chair
CHC Coordinator
CHC Nurse Assessor
CHC Practitioner
Clinical Fellow
Clinical Lead
Clinical Nurse Manager
Clinical Nurse Specialist
Clinical Practitioner
Clinical Research Nurse
Clinical Trials Officer
Clinician
Community Care Nurse
Community Matron
Community Mental Health Professional
Community Pharmacist
Community Psychiatric Nurse
Community Support Worker
Complementary Therapist
Complex Care Manager
Complex Care Nurse
Connect Advisor
Consultant
Consultant Neurologist
Continence Adviser
Counsellor
Day Care
Day Services Lead
Dementia Manager
Dementia Nurse Specialist
Dental Nurse
Dentist
Deputy Care Home Manager
Deputy CEO
Deputy Director of Care
Deputy Head of Care
Deputy Manager
Dietician
Director of Centre
District Nurse
Doctor
Domiciliary Care
Duty Manager
DWP Home Visiting Service
Education / Training
Education Adviser
Executive Director
Eye Clinic Liaison Officer
Eye Specialist
Falls Clinic Team
Food Consultant
General Practitioner
Generic Therapy Technician
Geriatrician
Head of Care
Head of Services
Healthcare Assistant
Heath Care Assistant
Hon Doctor of Science
Hospice Care/Support
Hospice Nurse Specialist
Hospital
Housekeeper
International Contact
Keyworker
Lecturer Practitioner in Palliative Care
Local Group
Long Term Conditions Coordinator
Manager
Massage Therapist
Medical Director
Member of CCG
Mental Health Nurse
Movement Disorder Nurse
Movement Disorder Specialist
Neuro Coordinator
Neurologist
Neuro Nurse
Neuro Team
Nurse
Nurse Manager
Nurse Specialist
Nursing Assistant
Nursing Home
Nutrition Nurse Specialist
Nutrition Support Team Leader
Occupational Therapist
Occupational Therapy Assistant
Older Persons Specialist Nurse
Ophthalmologist
Orthoptist
Outreach Worker
Palliative Care Consultant
Palliative Care Matron
Palliative Care Nurse
Palliative Nurse
Paramedic
Patient Liaison and Support Officer
Patient Liaison - Pharma
PD Liaison Sister
PD Local Adviser
PD Nurse Specialist
PD Service Manager
Pharmacist
Physician
Physiologist
Physiotherapist
Podiatrist
Practice Development Support Nurse
Professor Clinical Neurology
Professor of Cognitive Neurology
Professor of Neurology
Professor of Neuropathology
Professor of Neuroscience
Project Co-Ordinator
Project Support Assistant
Psychiatrist
Psychologist
Psychotherapist
Rare Neuro Nurse
Regional Care Development Advisor
Registrar
Rehab Assistant
Research Assistant
Research Coordinator
Researcher
Research Nurse
Residential/Nursing Home Manager
Residential Home
Respite
SCA (PSPA Specialist Care Adviser)
Senior Lecturer
Senior Neurology Registrar
Senior PA
Service Coordinator
Service Manager
Sleep Clinic
Social Care Team
Social Prescriber
Social Worker
Specialist Doctor
Specialist Matron in PD
Specialist Nurse
Specialist Paramedic
Speech & Language Therapist
Staff Nurse
Stroke Adviser
Student
Student Nurse
Support Manager
Support Nurse
Support Worker
Team Leader
Therapy Assistant
Therapy Consultant
Therapy Manager
Training Manager
Trustee
Tutor
Urologist
Volunteer
Ward nurse
Welfare Officer
Welfare Rights Adviser
Other Job Title
Work Address Street
Work Address Town / City
Work Address County
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Aberdeenshire
Aberdeen City
Argyll and Bute
Angus
Co Antrim
Co Armagh
Avon
Bedfordshire
Berwickshire
Buckinghamshire
Berkshire
Bristol
Caithness
Cambridgeshire
Caerphilly
Ceredigion
Cheshire
Clackmannanshire
Cleveland
Cumbria
Carmarthenshire
Cornwall
Conwy
Derbyshire
Denbighshire
Devon
Dyfed
Dumfries and Galloway
Dunbartonshire
City of Dundee
Dorset
Co Down
Co Durham
East Ayrshire
City of Edinburgh
East Dunbartonshire
East Lothian
East Renfrewshire
East Yorkshire
Essex
East Sussex
Falkirk
Co Fermanagh
Fife
Flintshire
Guernsey
Glamorgan
Glasgow City
Gloucestershire
Gwent
Greater Manchester
Gwynedd
Hampshire
Herefordshire
Highland
Hertfordshire
Humberside
Isle of Man
Isle of Wight
Inverclyde
Jersey
Kincardineshire
Kent
Lancashire
Co Londonderry
Leicestershire
Lincolnshire
London
Middlesex
Mid Glamorgan
Montgomeryshire
Midlothian
Monmouthshire
Moray
Merseyside
North Ayrshire
Northumberland
Norfolk
North Lanarkshire
Northamptonshire
Neath Port Talbot
Nottinghamshire
North Yorkshire
Orkney Islands
Oxfordshire
Pembrokeshire
Perth and Kinross
Powys
Rhondda Cynon Taff
Renfrewshire
Ross and Cromarty
Roxburghshire
Rutland
South Ayrshire
Scottish Borders
Suffolk
South Glamorgan
Shropshire
South Lanarkshire
Somerset
Sark
Surrey
Sussex
Stirlingshire
Staffordshire
Swansea
South Yorkshire
Torfaen
Tyne and Wear
Co Tyrone
Vale of Glamorgan
Warwickshire
West Dunbartonshire
West Glamorgan
Wiltshire
Western Isles
West Lothian
West Midlands
Worcestershire
Wrexham
West Sussex
West Yorkshire
Yorkshire
Shetland Islands
Work Address Postcode
Work Email Address
Mobile Number
Work Phone
Preferred Phone
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Mobile
Work
How did you hear about PSPA
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E-Newsletter
Event
HSCP
Media
Other
PSPA Matters
Search Engine
Social Media
Website
Word of Mouth
Introduction From
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Research Project Grant Application
Further Information
Sex
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Female
Male
Nonbinary
Not Listed
Prefer not to say
Unknown
Other
Pronouns
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He/Him
She/Her
They/Them
He/They
She/They
Not listed
Ethnicity
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Any other ethnic groups
Asian or Asian British - Any other Asian background
Asian or Asian British - Bangladeshi
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Black or Black British - African
Black or Black British - Any other Black background
Black or Black British - Caribbean
Chinese
Mixed - Any other mixed background
Mixed - White and Asian
Mixed - White and black African
Mixed - White and black Caribbean
White - British
White - Any other category
White - Irish
Not Stated
Prefer not to say
Could you help us with our work?
PSPA is interested in working with HSCPs to further awareness and understanding of PSP & CBD. If you feel you can contribute to any of the activities below and would like to help us then please tick the appropriate boxes:
Speak at PSPA Events
Contribute to PSPA Matters
Contribute to new literature for HSCPs
Fundraising
Volunteering
Communication Preferences
We would like to continue to keep in touch with you to tell you about the vital work we do for people with PSP or CBD, our fundraising activities, and opportunities to support us as well as the services we provide.
Please select all the ways you would like to be contacted:
I would like to receive communications by email
I am happy to be contacted by phone
I do not wish to be contacted by PSPA
You can change your marketing options at any time by contacting us by email:
consent@pspassociation.org.uk
; telephoning us on 01327 322 410; or writing to us at PSPA, Margaret Powell House, 415a Midsummer Boulevard, Milton Keynes, MK9 3BN.
Registered charity number England and Wales 1037087 and Scotland SCO41199
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