Evolving Mindset CIC Referral Page

Evolving Mindset are a non profit organisation based in Merseyside. We are a Community Interest Company, providing bespoke mental health workshops for individuals with mild to moderate common mental health difficulties and/or carers/family members. We are not a Clinical Mental Health Service - we still advise to seek advice from your GP or professional team if needed.

This form is to help us understand you better and how we can tailor our support to you. This form should take less than 5 minutes to complete. Any information you provide will be treated as sensitive and confidential and will not be shared without your permission.

This Project is funded by Hill Dickinson to help support adults living in the Merseyside area who may be experiencing mental health difficulties or to improve their knowledge around mental health & Well-being

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* 1. What is your name? (optional)

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* 2. What is your age

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* 3. What Gender do you identify with?

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* 4. What is your ethnicity?

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* 5. Area of GP

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* 6. Where did you hear about us?

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* 7. What area support are you hoping to receive by attending Evolving Mindset workshops?

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* 8. Please leave your email address below and one of the Evolving Mindset Team will contact you as soon as possible. You will be sent zoom links for the workshops via the e-mail address provided.

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* 9. I do/do not consent for Evolving Mindset CIC to contact me

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* 10. Are there any special requirements that Evolving Mindset may need to make prior to you attending our workshops?

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* 11. We all know that getting support can be tough, and one thing that makes it easier is confidentiality. At Evolving Mindset we’ll always handle your information confidentially. We ask that you maintain the confidentiality of others who come along to our groups too

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