Have your say form in Easy Read

Adapt our template to create your own Easy Read version of your Have Your Say form.
Three women including a clinician are standing in a hospital corridor reading a document.

We have created an interactive Easy Read version of our Have Your Say webform to help more people have their say on health and social care services.

We have adapted this into a template for any local Healthwatch who use our Have Your Say form on their website.

This document is best suited for being printed and completed by hand. 

Please note the supplier who produced this for us is happy for you to use it and add your own logo and contact details - but please don't change the wording of the questions or the pictures associated with each question. 

How to use this template

You must have a Canva account

  • Click on the Canva link;
  • Click on 'File' then 'Make a copy';
  • Edit the parts underneath the red stars;
  • When you've made your edits, delete the red stars;
  • Save the file in PDF format.

Easy read form Canva link

Don't forget data protection

For any activity where you’re collecting people’s data, you’ll need to provide information explaining the lawful basis as to why you’re collecting data and how you’ll use it.  You can do this by linking to your online privacy notice that outlines your data processing practices. This must include your lawful basis for processing personal data (information which could identify people) and special category data (including any data about health and wellbeing, ethnicity and sexual orientation).  Read our guidance on data protection.

If your lawful basis for processing personal data is consent, you’ll need to add a consent statement to your form.

Take a look at our guidance on consent for suggested wording for consent statements on webforms and separate statements for explicit consent (if that is your lawful basis for processing special category data).

Read our guidance on consent