Please download the form by clicking on the PDF tab on the right hand side.
We ask you to complete this form so that we have the right information to provide you with the best support for you. We are unable to work with anyone who has not provided us with a completed form.
Who can fill in the form?
Our services are for over 18's, unless otherwise stated.
There is no upper age limit, so as long as you are able to take part in and contribute to the activity of your choice S2R is here for you.
(Please note we are unable to support individuals who need personal assistance)
You can fill in the Application Form yourself, or ask a GP, Support Worker, friend/relative to fill it in on your behalf.
We ask for some details like your gender, ethnicity and date of birth, so we can monitor our service and make sure that we fulfill our Equality and Diversity policy.
Information Sharing and Consent:
S2R will retain electronic information about you so that we can provide you with the best level of support whilst you access our service. This information will be held in strict accordance with the 2018 General Data Protection Regulation (GDPR). We will only use your information for the purposes we have told you about, operational reasons and when we are required to do so by law (e.g. during an audit). We will also comply with any legal request by a court or authorised body that requires us to release information to them.
We will only share your information on a ‘need to know’ basis with other agencies involved in your support, in order to ensure consistency in the service you receive. Examples of agencies may be: Care Coordinators, Social Workers, Housing Providers, GP’s, Support Workers, CPN’s, Emergency Services etc.
Where do I send the downloaded form?
When you have completed the form, please return it to S2R in person or by post / email: see details at the bottom of this page.
What happens once we’ve got your form?
A staff member from S2R will contact you within 7 working days and invite you either to discuss the sessions you wish to attend or give you details of how to attend a session, depending on what you are interested in.