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Testing Gravity Form - Standalone

Application form for Family Carers - Veda Test

Fill out the form to join the Family Carers’ Email Network

  • 1. About yourself

  • For example, English, Polish, Punjabi. Please leave blank if you do not wish to disclose. We collect this information as it helps to ensure we are inclusive, and we use it in our funding bids which allow the family carer email network to continue.
  • Please pick from the drop down next to which box best describes your background. Please leave blank if you do not wish to disclose. We collect this information as it helps to ensure we are inclusive, and we use it in our funding bids which allow the Family Carer Email Network to continue.
    You can get more information about Headspace, the meditation and mindfulness app, at https://www.headspace.com
  • 2. About your family member with challenging behaviour

  • NB this network is only for people whose relative has a severe learning disability
  • E.g. ASD, Down Syndrome, Smith Magenis etc.
  • This field is for validation purposes and should be left unchanged.