Your Hospital - Luton and Dunstable Hospital - NHS Foundation Trust

Become a member of Luton and Dunstable Foundation Trust and you'll join a fast growing community of local people who have more say over local healthcare. Becoming a member is totally free and has many benefits, not least helping to shape a world-class healthcare service.

To get started, just fill in the form below.

If you are already a member, please click here.

First Name

Last Name

Post Code

1. Select a member type Member of the public within the catchment area L&D Staff Member Registered Volunteer
2. Are you a registered L&D volunteer? *
   YesNo
3. TitleMrMrsMiss
4. First name*
5. Surname *
6. Mobile number
7. Home number
8. Address *
9. Town
10. Post code *
11. Email address *
12. Confirm email address *
13. Gender *
    MaleFemale
14. Date of birth *
15. How did you hear about becoming a member?From an existing member or governorWebsiteHospital appointment letterAt the local libraryAt the doctor's surgeryLocal pressAt the hospitalIf other, please give details...
    Other:
16. EthnicityBangladeshiPakistaniBritishIrishAfricanCaribbeanAny other black backgroundWhite and black AfricanWhite and black CaribbeanChineseAny other ethnic group, please specify...
    Other:
17. In the last five years, I have not perpetrated a serious incident of violence against the Foundation Trust's hospitals, facilities, employees, registered volunteers or people exercising functions for the Foundation Trust
18. Submit
    Submit