Foot care campaign - case study request

We are looking for compelling stories to illustrate a major campaign that [will run this year]. - we are running

We need people who would be willing to speak to journalists and/or have their stories appear in campaign material.

The charity is looking for older people who:

find it difficult to care for their feet due to illness or inability to reach their feet and are forced to pay a private practitioner or go without
people whose health, well being and quality of life have suffered as a result, for example their mobility is affected, they become housebound and isolated and unable to perform basic daily tasks
people who are having to wait unacceptably long for NHS services
people who have resorted to extreme measures to try and cut their toe nails
are willing to talk to journalists from the TV, radio and/or newspapers
or are willing to let us use their story in an anonymous way in campaign literature
people who find that they have to wait too long between appointments for foot checks

If you are able to help please completed this form. Your support could make a major difference to the work of the charity.

Name*
Age*
Clinic or hospital*
Area*
Person telling the story (if not person in question please indicate how you know them)
Would you be willing to speak to (please circle as appropriate)
Print journalists?*	Yes No
Have your photo taken?*	Yes No
Speak to broadcast journalists and be filmed if asked?*	Yes No
Would story in campaign material need to be anonymous?*	Yes No
Age Concern would never put a journalist in touch with you or your family directly without your prior agreement. All calls are vetted by the media team and your first point of contact would always to a member of Age Concern staff.
Tel no
Email*
Story* (including specific examples of how your health, well being and quality of life are affected due to the lack of foot health services or excessive waiting times for chiropody on the NHS. If a complaint was made, how did the NHS podiatry department respond to it?)

We would like to keep you informed about Age Concern's charitable activities. Please tick the box if you DO NOT wish us to:
	tell you about our charitable activities
	pass your details to the trading companies of Age Concern England, Age Concern Scotland and Age Concern Cymru so that they can inform you about their products and services
	pass your details to other reputable organisations