The information you provide in this form is stored by Midlands Partnership University NHS Foundation Trust. Your information will be kept secure by the Diverse Communities Project Worker, and will remain confidential and not shared with other services, unless we have reason to believe you or someone else is at risk of harm and the information in this form is relevant to keeping you safe.
If you would like more information relating to your rights concerning your information, and the way the Trust handles your information, please read our Privacy Notice.
Please note: by completing this form you are giving us your permission to contact you by telephone and agreeing to all the terms described in our Privacy Notice.
We are a very small team so it may take 1 to 4 weeks to contact you, depending on demand, we appreciate your patience.