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Carers in Mind

Registration Form


Support for the carers, friends, and family of people with mental health challenges

For more information about how we use and store your personal information, please see the data protection and confidentiality statement at the bottom of the form.

Please note that fields with a red * are compulsory, and you cannot submit this form if they are not completed.

Identity

Address

Contact

Consent

Demographic

Other Information

SERVICE SPECIFIC: CARER INFORMATION

SERVICE SPECIFIC: CARED FOR INFORMATION

Data protection and confidentiality statement 

 

This information will be recorded on the Carers in Mind secure database and will be managed in line with the General Data Protection Regulation, Data Protection Act 2018. Carers in Mind may share general data (excluding any personal data such as names, addresses, and contact details) with statutory and voluntary partners for statistical purposes in order to monitor the effectiveness of services for funding applications and reporting. Confidential and personal information is not shared with anybody outside RB Mind without your written permission unless there is a potential risk to yourself or others when we would have a legal obligation to pass on information.  

 

If you would like to see our data protection policy and our privacy statement, please see the Richmond Borough Mind website: https://www.rbmind.org/privacy-policy/   

 

By submitting this form I agree for this information to be used as stated above.