I agree that:
This information can be stored on a secure system that is managed by Crossroads. I understand that it will be treated as confidential and can only be accessed by Crossroads staff.
This information can only be passed on to other organisations i.e. training, leisure, education or employment with my consent (tick box below)
My name may be placed on an e-mail list of Carers for consultation purposes. Only Crossroads will use this list.
I may withdraw this information from the mailing list at any time by contacting Crossroads Birmingham on 449 1485 or by post to Birmingham Carers Centre, Colmore Row, Birmingham, B3 3AP
I consent to my contact details being passed on to relevant leisure, training, education and employment organisations that work in partnership with Crossroads. Yes No
