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Queer Minds

Client Registration Form


Thank you for your interest in South East London Mind (SEL Mind)'s LGBTQIA+ peer support group: Queer Minds. The group meets fortnightly on Tuesdays 6:30-8:30pm. Visit our website (selmind.org.uk/queermindsls) for more details.

If you would like to register your interest to attend any of our Queer Minds sessions, please complete this form. 

Please note that all fields with a red * are compulsory and must be completed before you can submit this form.

Identity

Address

Contact

Dietary requirements

Accessibility Needs

Your requirements

Referral Information

Thank you for completing the first part of this form.

Only SEL Mind will have access to this information. 

Please click Submit to go to the next part of this form, which we would appreciate you completing.

Only when you have you have completed BOTH this form and the NEXT form, will they be sent to us for review.