Second Step Wellbeing Colleges Booking Form

Booking Form (Alignment Project)

Region

Which regional area do you live?

Region

Your wellbeing workshops

You can apply for up to three workshops, simply select each workshop from the three drop-down lists below.

Workshop 1

Additional Support

If you would like to bring someone along to support you at this session, please give their details below:

(please enter telephone number without spaces)

Workshop 1

Additional Support

If you would like to bring someone along to support you at this session, please give their details below:

(please enter telephone number without spaces)

Workshop 2

Additional Support

If you would like to bring someone along to support you at this session, please give their details below.

Workshop 2

Additional Support

If you would like to bring someone along to support you at this session, please give their details below.

Workshop 3

Additional Support

If you would like to bring someone along to support you at this session, please give their details below:

Workshop 3

Additional Support

If you would like to bring someone along to support you at this session, please give their details below:

South Gloucestershire Residents

Wellbeing workshops are currently provided for South Gloucestershire residents by the One You service run by Southern Brookes.

Second Step don't provide workshops for the South Gloucestershire region at the moment, but if you have been received support for your mental health by NHS Talking Therapies, Vita Minds or any other Bristol based mental health service, please select Bristol as your region of origin.

Referral Details

Are you completing this booking form your yourself or someone else?

*

Has the learner given consent for you to complete this form

*
 

Please talk to the person you are looking to refer to our service before completing this form on their behalf.

Does the learner want us to update you with the outcome of this booking form?

*

What is the nature of your relationship to the person you are completing this form for?

*

Contact Details

(please enter telephone number without spaces)

Have you attended our workshops before?

*

Enrol with us

You will need to enrol our service before we can accept you onto any workshops
(please enter telephone number without spaces)

What support are you receiving?

Please choose from the following options:

Are you registered with a GP Surgery?

 

We are unable offer North Somerset based workshops to anyone who aren't registered with a GP Surgery.

Emergency contact details

In case of concern or emergency, please supply contact details for your next of kin or support worker:

Support needs

Please tell us about any physical or mental health support needs (eg, handouts in large print; wheelchair access).

Equality and diversity information

Please help us improve equality, diversity and inclusion in our service by completing the following questions

How did you discover us?

How did you discover us?

If you have previously enrolled with Bristol Wellbeing College, have you had a change of name or address since your last attended workshop?

New Personal Details

Using your information

At Second Step, protecting your personal information is very important to us and we will ensure your personal data is kept confidential and held securely.

We use a great deal of information in our services. For example, we process information about current and past service users working with us or receiving support or tenants in our accommodation. For each service Privacy Policies will be presented directly to these individuals in an upfront way, to ensure they clearly understand how we will use their information.

To find out how we use, store and protect information obtained for these purposes please read our
protecting your personal information leaflet [opens as a PDF]

Please note:

Owing to the volume of applications, enrolment takes a minimum of two to three working days to process. If you wish to attend a workshop or course in the next two to three working days please complete your online application and then call the Wellbeing College on 0117 914 5498 to ensure we are able to offer you a space.

Regretfully, the Wellbeing College is unable to accept learners who are not enrolled.