Carers Wellbeing Check

We work in partnership with Birmingham Carers Hub and we need to ensure our wellbeing services are making a difference. Please complete the Wellbeing Check as fully as you can. You’ll be asked to complete this online form at regular intervals

    Your Details

    [cf7mls_step cf7mls_step-1 "Next" ""]

    1. Your Health and Wellbeing

    [cf7mls_step cf7mls_step-2 "Back" "Work, Education and Training >" "Step 2"]

    2. Work, Education and Training

    [cf7mls_step cf7mls_step-3 "Back" "Your Financial Situation >" "Step 3"]

    3. Your Financial Situation

    [cf7mls_step cf7mls_step-4 "Back" "Time Out >" "Step 4"]

    4. Time Out

    [cf7mls_step cf7mls_step-5 "Back" "Caring and family commitments >" "Step 5"]

    5. Other caring and family commitments

    [cf7mls_step cf7mls_step-6 "Back" "Relationships >" "Step 6"]

    6. Relationships

    [cf7mls_step cf7mls_step-7 "Back" "Your Home >" "Step 7"]

    7. Your Home

    [cf7mls_step cf7mls_step-8 "Back" "Your Diet >" "Step 8"]

    8. Your Diet

    [cf7mls_step cf7mls_step-9 "Back" "How Safe do you Feel >" "Step 9"]

    9. How Safe do you Feel?

    [cf7mls_step cf7mls_step-10 "Back" "Additional Info >" "Step 10"]

    Additional Notes and Actions

    [cf7mls_step cf7mls_step-11 "Back" "Consent >" "Step 11"]

    All uses of personal data are controlled by the Data Protection Act (amended by the General Data Protection Regulations GDPR). Please see the Council and Birmingham Carers Hub website for their privacy statements www.birmingham.gov.uk/privacy and http://forwardcarers.org.uk/privacy-policy/

    Carer Consent Statement

    I understand that I am giving my personal information to Birmingham Carers Hub, on behalf of Birmingham City Council and other professional agencies you are working with; and you will keep it safe and only use it to assess my needs and help plan my care support. I understand that I can take away my consent at any time. I understand that without consent, this will make it difficult to assess my needs and arrange the support I need.

    I am aware that I can say if there is any particular organisation that I do not want to see my information, and you will not share it with my relatives or friends without my knowledge or agreement. I understand that there may be exceptional circumstances where the law says Birmingham Carers Hub must show/share this assessment with someone else. The information I give is true and accurate and I understand that action maybe taken against me, if I have given false information.

    [cf7mls_step cf7mls_step-12 "Back" "Step 12"]

    How To Find Us

    7 High Street
    Harborne
    Birmingham
    B17 9NT
    T: 0121 426 2633
    E: hello@barefootharborne.co.uk

    Barefoot Yoga Harborne Ltd. Company number 12553712

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