Mindspace Peer Support Enquiry Form
Date of Birth (DD/MM/YYYY)
Prefer not to say
Town / City
Can we leave a message on this number?
Why are you interested in Peer Support?
Do you have a disability or any special access requirements?
How did you hear about us?
Data Protection Statement
by law, we will give your details to appropriate third parties.
Do you consent to us keeping your details for the purposes outlined above?
In addition and separately from using personal information as described above, we would like to contact you from time to time with details of other courses or events we are running. Are you happy to receive this communication?
If yes, how you would like us to communicate with you