Wellbeing and Mental Health Provisions Membership status*Please confirm that your organisation, group or project is a Consortium Member Yes No The wellbeing and mental health directory is only open to existing Consortium Members.If you would like to find out more about the benefits of becoming a Member and how to join, please click here.Name of Organisation, Group or Project*Please give the name of your organisation, group or project Name*Please provide the full name of the relevant contact person within your organisation First Last Pronouns Email Address*Please give the email address of the key contact person Enter Email Confirm Email Phone Number*Please provide the phone number of the key contact personService provisions*Please select all options that your organisation provides below: Wellbeing group activities Wellbeing 1:1 support Peer support Therapeutic/counselling group support Therapeutic/counselling 1:1 support Client target groups*Please select all options that your organisation provides below: Children and young people (under 18) Adults 18+ Service delivery*Please select all options that your organisation provides below: Online/remote support Telephone support In person support Where do you provide your in-person support?*Use the 'plus' (+) icon on the right-hand side to add as many rows as you need to list all of the locations where you provide in-person support. Please use this space to provide details of any other specific services that you provide or any other client groups that you support, including any essential referral criteriaService costs*Please select all relevant options below: Free to all services users Costed with a sliding scale Costed with a fixed rate Consent*All information entered on this form will only be used to administer and run the wellbeing directory. Please refer to our Terms & Conditions if you have any questions about how we handle data privacy. I agree to the above privacy policy
