Please complete the below form to register your interest in attending a Look Good Feel Better Teenage & Young Adult service. Once completed, one of our team will contact you to organise a workshop.

Please make sure to enter in the correct contact details so we can reach you.

First Name

Surname

Contact number

Age Bracket

Please confirm that you have received parental/guardian consent to attend workshops with LGFB.

I confirm that I have received parental/guardian consent to attend workshops with LGFB

Parental or Guardian Full Name

Parental or Guardian Contact Details

Person named above's relationship with you (eg mother/father)

My pronouns are

What service/s are you interested in attending? (Select as many as you'd like)

Face to Face Skincare and MakeupVirtual Skincare and MakeupVirtual Hand & Nail CareVirtual Skincare & Grooming (facial shaving)

What's your nearest Town or City?

We need your postal address (for a gift bag to be organised after the workshop!). What is the first line of your address?

Town/City

Postcode

Main hospital which you are being treated at

Town/City of the hospital which you are being treated at

Name of your Youth Support Worker or Co-ordinator