Leach Heath Medical Over 65s Please enable JavaScript in your browser to complete this form.If you are a patient of Leach Heath Medical Centre aged 65 and over and you need advice on cost of living, bills or welfare benefits eligibility our social prescribing service can speak with you local services that may be able to assist you. Social prescribing is about helping people get connected to activities and services in their local community. If you would like to speak to the Social Prescribing Link Worker for Leach Heath Medical Centre, just fill in the below form and we will contact you as soon as possibleName *FirstLastDate of birth: *Address including postcode: *Your contact telephone / mobile number: *Please indicate if you would prefer a face-to-face meeting or telephone call: Face-to-faceTelephoneGDPR Agreement *Tick to confirm : I consent to be contacted via telephone or SMS by the social prescribing service to arrange an appointment to discuss my personalised care and support plan.GDPR Agreement *Tick to confirm: I give consent for my social prescribing link worker to update my shared care record at my GP surgery with any conversations or referrals related to my personalised care and support plan.GDPR Agreement *Tick to confirm: I agree to the data protection policy of The Active Wellbeing Society. How information about you will be used: Information you provide is collected and stored securely by The Active Wellbeing Society Limited, a charitable community benefit society (No. 7595), and Turning Point, a charitable organisation (No. 234887) working in partnership with OHP. We and our partners will hold this information in confidence and comply with all our responsibilities under the General Data Protection Regulation and Data Protection Act 2018. For details about both TAWS and Turning Point’sPrivacy Policies please visit www.theaws.co.uk/privacy-policy and www.turning-point.co.uk/privacy-policySubmit