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Your Experience survey

If you have used our Hospice's services, please consider taking some time to inform us of your experience.

Media request form

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  • To help us get in touch if we have questions about your request
  • Who?

    In this section we hope you can teach us about the people behind the story. Who is organising it? Are they a determined individual? A group of people from a local company? Have they been friends for years? Are they a local group? How can we get in touch with them? Please save the 'why they are doing it' for the designated section below.
  • What?

    Tell us what is going on or what has happened. Is it an event? Are you making a donation? Did it involve a lot of planning? Did you face any challenges? Is it an annual event?
  • Where and when?

    Time, location and where can people find out more/buy tickets? When and where is it happening/happened?
  • Why?

    What are the reasons behind the story? Is it in-memory of a loved one? Are you trying to tell more people about a Hospice service? Do you think its an important local cause? Is it a remarkable story about a volunteer?
  • Photograph

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    Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB.
    • Thank you for agreeing to participate in the Hospice's promotional activity

      St Nicholas Hospice Care wishes to use your story and/or images, video or audio for the purposes of promoting and marketing of the Hospice, its services and fundraising events.

      We would like your permission to publish this material now or in the future. This might be in a newspaper, on Facebook, leaflets, on our website, or for promotional/branding items, such as posters, billboards, roller banners or window displays in our shops. We may also use the information you have provided for applications we make for funding or grants.

      Before using your photographs, name, quotes, video or audio we need your permission. Please complete this form.

    • Contact details

      Your details are collected and stored for the purposes of managing the media you have consented for use by the Hospice.
    • Use of your image

    • Declaration

      I understand that:

      The Hospice may use my or child's image, voice, words and name in content distributed on publicly available media (online and offline).

      The Hospice may use my or child's image and name in the production of promotional materials, publications, and article for marketing and publicity purposes.

      I can withdraw consent for this at any time. I can contact or the organisation's Data Protection Officer if I change my mind.

      Images that are already published can be difficult or impossible for St Nicholas Hospice Care to retract from circulation. The following policies are available to me if I wish to read more about the Hospice's policies: Data Protection and Management policy, Media Policy, Consent Policy.

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      Administrative use

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