Please complete this form with your referral agent
The information gathered will be collated by the coordinator of the Neighbourhood Renewal Health Improvement Project for Craigavon. This is so that you can be contacted and signposted to the most appropriate activity available through this project for your health and wellbeing needs.
Your personal information will be held securely in line with current data protection principles so that engagement in this project can be processed, monitored and evaluated.
For further information please see the SHSCT privacy notice
If you have any concerns you have a right to register a complaint with the project coordinator by emailing email@example.com