ICB CNN Application Form

Please complete this form to request to join the Integrated Care Board Chief Nurse Network (ICB CNN).

If you are already a member of the network, and you would like to update your details, please contact Edina Peto.

Name(Required)

First Last

Job title(Required)

Email(Required)

This will be the email used to send all network updates & will be stored on our email marketing system and database

Enter Email Confirm Email

Organisation name(Required)

Organisation address

Street Address Address Line 2 City County/Region Postcode Country

Your scope of responsibility within integrated care systems(Required)

E.g. the services for which you have executive responsibility

What would you like to gain professionally from being a member of the network?(Required)

What issues related to clinical leadership within integrated care systems would you like to see raised and discussed within the network(Required)

Twitter handle

If applicable

About the Network