Compassionate Bodies Peer Support Group referral/ information form

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Compassionate Bodies Peer Support Group referral/ information form

Welcome! Thank you for your interest in the Compassionate Bodies peer support group. This form helps us understand who is interested and how we can make the space feel as safe and supportive as possible. You only need to share what feels comfortable, there is no pressure to answer everything.

Email *

Record my email address with my response

Referral type

Are you completing this form for yourself or someone else?

I am completing this for myself (self-referral)

I am completing this on behalf of someone else (with their consent)

If referring someone else: give the name of the referrer, role/organisation, contact details

I confirm that the person has given consent for this referral

About the Space (Please Read)

Compassionate Bodies is:

A peer-led space for mutual support and connection

A place where people can share experiences around their bodies and senses

It is important to know that:

This is not a therapy group or clinical service

We do not provide medical, therapeutic, or professional advice

This group does not replace professional mental health or medical support

Participation is completely voluntary, and you are free to share as much or as little as you like

The facilitator takes part as a peer within the space. They are not acting as a healthcare professional and are not providing therapy or professional advice.

Support & Needs

What has brought you to the group?
(You’re welcome to keep this brief or skip if you prefer)

Do you have any access needs we should be aware of?
(e.g. mobility, sensory, communication) *

Important to Note

Compassionate Bodies is a peer support space, not a crisis or medical service.

If you are in urgent distress, you can contact:

Your GP

NHS 111

Consent

Please tick to confirm:

I understand the nature and purpose of this peer support group

I understand that this is not clinical service

I agree to take part on a voluntary basis

Required

Privacy Notice (UK GDPR)

We collect your name, contact details, and any information you choose to share about access needs or health related information in order to:

Register your interest
Tailor support
Support the safe running of the group

Our lawful basis under UK GDPR includes:

Consent
Legitimate interests (to run safe and supportive sessions)
Legal obligations (e.g. safeguarding)

Your data will be stored securely and only accessed by the facilitator or those with a legitimate need to access it. We will retain your information only for as long as necessary to fulfil the purpose for which it was collected , after which it will be safely deleted.

You have the right to:

Request access to your data
Request correction or deletion

To do so, contact compassionatebodiesproject@gmail.com

Data Controller: Compassionate Bodies Project

Please tick to confirm:

I have read and understood the Privacy Notice and consent to my data being used as described

I consent to the Compassionate Bodies Project processing my personal and health/wellbeing data as described above.

Required

What Happens Next

After you submit this form, we will be in touch to arrange a short, informal “getting to know you” chat.

This is a chance to:

Share a bit more (if you’d like)

Ask questions

See if the group feels right for you

There is no pressure to join, you’re welcome to take your time deciding.

Closing

Thank you for taking the time to complete this form. We really appreciate it.

Send me a copy of my responses.

Submit

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