Action Network

Covid-19 Bereaved Families for Justice Media Spokespeople Details

Not in the US?

Which form of media are you happy to tell your story to? What time are you generally available to speak to the media? Please tick all that apply. * Pre-record TV Live TV Pre-record Radio Live Radio Print None of these

Which month did you lose your loved one/s? * March 20 April 20 May 20 June 20 July 20 August 20 September 20 October 20 November 20 December 20 January 21 February 21 March 21 April 21 May 21 June 21 July 21 August 21 September 21 October 21 November 21 December 21 January 22 February 22 March 22 April 22 May 22

Which of the following areas applies to your personal story and your lost loved one? What time are you generally available to speak to the media? Please tick all that apply. * Hospital Acquired Covid Care Homes 111 Key worker NHS worker Transport worker Do not attempt resuscitation order Underlying health conditions No underlying health conditions Black and Minority Ethnic Lack of PPE Late lockdown Loss of multiple family members Hospital failings Financial challenges as a result of bereavement I've helped volunteer on the vaccine programme My loved one had been vaccinated Other (Please type in next question)

If you feel comfortable please explain a little more of your story and the issues you’d be keen to highlight by speaking to the media

Which region did your loved one/s live in? * East Midlands East of England London North East North West Northern Ireland Scotland South East South West Wales West Midlands Yorkshire and the Humber Outside of the UK

What level of experience do you have in speaking to the media? * Lots of experience Some experience No experience

Do you have professional or voluntary experience in the Press Relations or Media industries? Is so please state what below

What time are you generally available to speak to the media? Please tick all that apply. * Monday Mornings Monday Afternoons Monday Evenings Tuesday Mornings Tuesday Afternoons Tuesday Evenings Wednesday Mornings Wednesday Afternoons Wednesday Evening Thursday Mornings Thursday Afternoons Thursday Evenings Friday Mornings Friday Afternoons Friday Evenings Saturday Mornings Saturday Afternoons Saturday Evenings Sunday Mornings Sunday Afternoons Sunday Evenings It changes every week

Are you prepared to be briefed before media appearances and help to emphasise the calls of the Covid-19 Bereaved Families for Justice campaign during any media appearances? * Yes No

Are you a member of any political party (Why do we ask this? > Spokespeople have previously been accused of impartiality due to political beliefs, it doesn’t stop us using you as a media spokesperson but it does help us to know in advance if you are a member so we can protect against this) *

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