Changes Bristol Membership Form
Hey there! Thank you for choosing to join the Changes Bristol Support Network.

There are just 2 quick steps to becoming a member:

1. Fill out the Membership Form below and the Equal Opportunities Questionnaire which follows it. You will then receive an email from our team within a few days.

2. One of our team will give you a welcome call to tell you a little more about the support groups, answers any questions you may have and make sure you are all set up to access them. We will try to call you as soon as we can (within 4 working days). Then you will be able to access all of our groups every week.

Membership gives you access to all areas of Changes Bristol's organisation including all support groups (online and in the community) and any other activities. Any data collected is for our own information only and will not be shared with third parties*. You have a right to request to see the data we hold on you, and to ask for it to be deleted at any time.

If you have any issues or questions please ring 0117 941 1123 or email
Email address *
Our groups are for anyone aged 18 or over. Please confirm your age. *
If you are under 18, please visit for mental health support in Bristol
First Name *
Last Name *
Phone Number *
We need your phone number so we can give you a welcome call to tell you a little bit about how the support groups work, make sure you've got all the right technology to access online groups, and hopefully alleviate any anxieties you may have about attending. Don't worry, we won't use it for any other purposes or pass it on to third parties.
What support are you interested in? (tick all that apply)
Address Line 1
Please enter the first line of your address. (Optional))
Address Line 2
Please enter the second line of your address. (Optional)
Post Code *
We need your postcode so that we know what areas our members are coming from.
How did you find out about Changes Bristol Support Meetings?
How would you describe your mental health difficulties?
e.g. Anxiety, depression, etc.
Have you had a diagnosis from a healthcare professional?
Clear selection
We would like to send your our monthly e-newsletter which includes news about mental wellbeing, our services and ways to get involved. Please tick below to confirm.
Occasionally we send out emails in relation to the following specific areas of the charity. Please tick any that you would like to hear about:
Would you like to be a voting member? *
This means you would be able to influence how the organisation is run and be able to vote in the AGM each year.
Key Information
All our support meetings are free to attend, but if you would like to make a donation as part of your membership you can donate at

*Information on this form helps to ensure quality of service and provides valuable data for our funders. Changes Bristol will never sell your personal information to third parties. See our Privacy Notice for more information on how we use and protect personal information. You can change your mind at any time by emailing

Our meetings are confidential but we may need to share information if we were concerned that someone is at risk of harm.

We are looking forward to meeting you online soon!
Never submit passwords through Google Forms.
This form was created inside of Changes Bristol. Report Abuse