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Home
What We Do
OVERVIEW
REGULAR CLASSES
SPECIAL EVENTS
CHILDREN & YOUNG PEOPLE
WELLBEING PROJECTS
CORPORATE & COMMISSIONS
Photo Archive
WHAT'S ON
Shop
Hire us
If you need any assistance with completing this form please email
dulcie@sketchappeal.co.uk
If signing up for Monday 4th December, you will receive the ZOOM link within 48 hours of registering.
Name
*
First Name
Last Name
Pronouns
*
I would like to attend:
*
Group session on Monday 4th December 7-8pm (ZOOM)
One-to-one session (27th - 30th December)
I can't do either but would be interested in future sessions
Please select which best describes your current status
*
I have been diagnosed with an eating disorder and am on an NHS waiting list for support
I have received some treatment in the past but my illness has endured
I am currently receiving some treatment through the NHS
Do you have any access needs, physical or learning disabilities?
Leave blank if the answer is no
Date of birth
*
Gender
*
What is your ethnic group?
*
White
Mixed/Multiple ethnic groups
Asian/Asian British
Black/African/Caribbean/Black British
Chinese
Arab
Other ethnic group
Email
*
Contact number
*
Postcode
*
Emergency contact name
*
Emergency contact number
*
Name of person who referred you to these sessions
*
If you would like to ask or tell us anything ahead of the sessions please write it here and we will respond accordingly.
Thank you!
