Healthy Lifestyles Scheme - Expression of Interest

The Healthy Lifestyles Scheme is available by referral from a health professional or self-referral.  
Our Healthy Lifestyles Instructors really understand long-term health conditions and can work with you to help you identify and achieve your goals.  Maybe you want to know what an appropriate level of activity looks or feels like? Perhaps you want to know which of our online classes would be suitable for you? Do you need some one-to-one support? 
If you can answer yes to any of these questions then register your interest by completing the details below so that we can get in touch with you for an informal discussion. 
If you are completing this referral form on behalf of someone else, you must have gained their consent to provide us with their personal data before progressing.  To understand how we keep and manage data you can view our privacy policy here.

1. Full Name *


2. Email address *


3. Postcode *


4. Contact Number *


5. Gender *


6. Which classe(s) are you interested in *


7. Would you prefer to be contacted by phone or email in the first instance? *


8. How did you hear about the Healthy Lifestyles Scheme?