Join Us | mysite

Membership form

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

Full name

Phone / Mobile

Home address & postcode

Emergency Contact: Name, Phone, Email

Would you like a phone call from one of our team? (If you select yes, you will be emailed to find a suitable time)

Yes

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

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 administration and to keep in touch. All information you provide will be held securely in accordance with UK GDPR and the Data Protection Act 2018.

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

Thanks for sharing!