Waltham Forest Somali Sisters Cycling Project 2024

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Salams and welcome!

We are so pleased that you are interested in this amazing project led by Cycle Sisters, and we hope you enjoy taking part.

Over the coming months, we will help with starting you on your cycling journey and hopefully you'll join us on our weekly Waltham Forest rides.

As part of this process, we have been asked to monitor the health of the sisters who are taking part, to measure impact. We would therefor grateful if you could complete this registration form. We will ask you you complete a second questionnaire after you have participated, either at the end of the project or if you leave prior to the end.

PLEASE NOTE:
Places can only be offered to Somali women who live, work or study in Waltham Forest.

If you have any questions, please speak to the Cycle Sisters leads who will be present at sessions or email sabeha@cyclesisters.org.uk

This project is funded by the GP Care Group CIC.

ALL INFORMATION YOU PROVIDE WILL BE KEPT STICTLY CONFIDENTIAL!

Email *

What is your first name? *

What is your last name? *

What is your phone number? *

What is your door number? *

What is your postcode? *

What is your date of birth? *

YYYY

What is your ethnicity? *

Do you consider yourself to have a disability? *

Yes

If yes, please can you give some detail?

What is your current cycling ability? *

I cannot balance and peddle

I can cycle but do not have full control

I can control a bike but do not feel like riding on the road/cycling in traffic

I can ride on the road but do not feel fully confident

I am confident riding on roads

How did you hear about the project? *

A friend

A family member

Social prescriber

Poster

Whatsapp Group

Community Centre

Newspaper/magazine

Social Media

Other:

Required

Please tick if you have been advised that you have or are at risk of developing the following: *

High blood pressure

Low blood pressure

Heart disease

Angina

Palpitations

Pre-diabetes

Controlled diabetes

Type 1 diabetes

Type 2 diabetes

Baby blues

Depression (including post natal)

Anxiety

Peri menopause

Menopause

Cancer or precancer

Not applicable

Other:

Required

In the past week, on how many days have you done a total of 30 minutes or more of physical activity, which was enough to raise your breathing rate. This may include sport, exercise, and brisk walking or cycling for recreation or to get to and from places. Include physical activity in and out of school/college and as part of your job etc *

Thanks so much for completing the form.
We will ask you to complete a further survey at the end of the project to see if it has helped you.
Please press submit.

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