Working Well Norfolk - General Interest Form

Please fill in the form below ensuring that all the “Required” boxes are complete. This information is needed for us to assess your eligibility for the programme.

Name(Required)

Title First Name Last Name

Email(Required)

Enter Email Confirm Email

Phone(Required)

Area(Required)

Where did you hear about us? Please select and specify details in the box at the bottom(Required)

Please specify name or location of the organisation / referral source(Required)

Your Personal Data

Seetec is committed to data security and the lawful , fair, and transparent processing of personal data. We will process the personal information you provide only for the purposes of joining the Working Well Norfolk Programme.

Your data will be retained only for as long as necessary to complete this process, and if you decide that you no longer wish to join the programme or your referral is not approved, your data will be deleted from our systems within 30 days of notification.

We may retain anonymised data (data which cannot be associated with you) for statistical and reporting purposes.

For further information on how Seetec processes personal data, please see our privacy policy.