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Membership form

Please fill out the following form to help us understand your condition.

Full name

Email

Phone / Mobile

Home address & postcode

Emergency Contact: Name, Phone, Email

Do you require help with transport for meetings? *

No

Yes

Do you have any suggestions of what you ideally would like from the group? *

No

Yes

If yes, please explain:

Where did you find out about us?

Please select this box to confirm you have read and understood ourPrivacy Statement

You understand that Herts Me / CFS Group will use your information for adminisitration and keep in touch with you in accordance with General Data Protection Regulations

Please select this box if you consent to having photos taken at our events shared on our social media

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Enquiries

© 2022 by Hertfordshire M.E / CFS Support Group

For enquiries please email hertsmecfs@gmail.com

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