Social Prescribing Webform South Birmingham Alliance PCN

Please complete the registration form below to access free activity sessions delivered by The Active Wellbeing Society and partners in your local area.

Please select the GP Practice you are registered with
This will support with ensuring medical records are accurately updated
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Selected Value: 0
Use the slider to select on a scale 0-10
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Use the slider to select on a scale 0-10
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Use the slider to select on a scale 0-10
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On a scale where 0 is “not at all anxious” and 10 is “completely anxious”,
ALL these activities will take place online and you will need access to internet
The Wellbeing Card is required to enable you to access the free activities. You will be issued with a membership card known as Wellbeing Card which you will receive in the post.
Privacy Notice How information about you will be used Information you provide is collected and stored securely by The Active Wellbeing Society Limited (community benefit society registered with the ICO; Reg. No. ZA266982), who provide services on behalf of Birmingham City Council, Sport England, Our Health Partnership/South Birmingham Alliance PCN. We collect this information to enable us to administer the membership we hold with you, to provide better services, to promote public health and physical activity and monitor the effectiveness of our programmes, to maintain our accounts and records, to prevent fraud and misuse of public funds and to report to our funders. We will keep this information during the time of your involvement with our services and for a period of 3 years afterwards. We may share anonymous information about you with our partner organisations and funders, in order to provide you with appropriate services, to monitor outcomes related to physical activity and healthy lifestyles and to facilitate research and insight. 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. By signing up, you agree to these terms. You have a right to withdraw your consent at any time at any time by contacting us on 0121 728 7030 or emailing [email protected]. If you would like a copy of our Data Protection Policy please visit http://www.theaws.org/privacy-notice Alternatively, you can find out more about your rights or complain to the Information Commissioner’s Office at ico.org.uk.