Telephone Buddies Registration
Use this form to register for services during the pandemic Coronavirus. By completing this form, you are offering your consent for the Denby Dale Centre to hold and use your information that is provided.  

Privacy Notice is posted at www.ddc.org.uk.  

This service is called Chatterbox - a volunteer phone buddy, that will call daily for an update about life

If you are completing this registration for someone else, please gain their consent to register on their behalf.


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Email *
I give consent for my personal data to be passed on to a local community organisation who will ask one of their volunteers to fulfill my request.
Clear selection
Name *
Address *
Telephone *
Next of Kin - Emergency Contact
In case your volunteer gets concerned about your welfare, could you tell us who we should contact on your behalf?
How many calls per week would you prefer?
Clear selection
Which days do you like a call?
Gender preference for caller?
Clear selection
List of any personal interests:
This will be passed on to the telephone befriender, to help conversation matter
Notes - do you need to tell us anything further?
For example any subjects that should be avoided, like bereavement, football, etc
Submit
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