Communications form for people who use Together services submission form

First Name *

Surname *

Are you currently using a Together service or did you use them in the past?

I'm currently using a Together service

I previously used a Together service

Which Together service are you currently using? (if you're unsure of the name a general description of the type and area or the person you worked with will help us work that out)

Which Together service was it you used previously? (if you're unsure of the name a general description of the type and area or the person you worked with will help us work that out)

Would you like to receive updates from Together on the work we're carrying out and our service users via our email bulletin?

Yes

No

Please provide your email address below for us to send the bulletin to (please note you can unsubscribe from that bulletin at any time):

Would you be interested in sharing your lived experiences by creating content for the Together website and to be posted on social media to share insights and increase awareness while providing support to others with similar experiences? (Please note the wellbeing of participants is the most important thing when creating any content for the comms team at Together and the best way to proceed will be decided through conversations to establish what the person is comfortable with and what is most appropriate)

Yes

No

Not sure, would want to want more information before deciding

Which of the following methods would you prefer us to contact you by to discuss this further:

Email

Phone call

Video call

What is the email address you'd like us to contact you on? (If you've already provided this in the form you can leave this blank)

What would be the best phone number to contact you on?

If there is a specific member of staff at the Together service you've worked alongside we can look to speak to them about sharing your story, if that would be useful please name that person below:

In the space below it would be great if you could let us know a little bit about your lived experience of mental distress and if there are specific topics you would like to speak about when sharing your story:

In the future Together would like to have a database of people currently using our services or who have used them previously to refer to share surveys with or to put out calls around specific awareness days or topics to be involved in. Would you like to be on that list?

Yes

No

Together will only use the information provided on this form for the reasons stated and will never share data with third party sources. You can unsubscribe from communications anytime or contact us to do so at comms-admin@together-uk.org and read more at our privacy statement at https://www.together-uk.org/privacy-notice/. Please tick the box below to confirm you agree to provide consent for your details to be submitted to the Together communications team:

*

I agree

What would you like to find?

Looking for something specific?

I’m a commissioner and I want to see what services you provide

I’m a social worker or care coordinator and I want to find a service near my client

I’ve been referred to one of your services and would like to learn more about you

Communications form for people who use Together services submission form

Communications form for people who use Together services submission form

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