The information provided by you on this form will be stored either on paper records or a computer system in accordance with the Data Protection Act 2018 .Any personal data herein are processed in accordance with the Data Protection act 2018. Should you require further information, please contact the support group membership team
Hearts & Minds Application Form
Join Hearts & Minds now....
It costs nothing
Please register your interest by sending a completed form to →
Or hand to either a nurse on the Cardiac Care Unit or staff on the Cardiac Rehabilitation Team.
This will ensure you receive copies of our newsletter and be informed of coming events.
Wendy Wright, Tel 01268 552701
c/o Cardiac Rehab Team,
Complete form by entering you details in each box, then click on Print Page below
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