Personal Stories

Personal Details

Full Name

Age

Occupation

Town (required)

WHAT - Westbank Services

Please provide information about the Westbank services you have accessed? (required)

WHERE - Location

Please provide information about the location of the services accessed e.g Healthy Living Centre, Coffee on the Corner, Starcross? (required)

WHEN

Please provide information about when the activities took place e.g one-off, regular, when they started/ended, over what period of time they took place? (required)

WHY

Please provide information about why you were referred, or self referred to Westbank? (required)

HOW

Please provide information about how the support you received improved your situation? (required)

The Westbank WOW Factor

In your own words, please provide a quote to capture the impact to you, of the support received from Westbank? (required)

Additional Information

Please provide any other relevant information?

Please tick to confirm follow up by a member of the Westbank Marketing Team (required)

YesNo

Consent Permissions

I consent to my Personal Story, photograph and name being used by Westbank Community Health and Care for the purpose of promoting the work they do as a Charity across Devon. This includes inclusion in Westbank publications, posters, promotional materials (required)

YesNo

By completing and submitting this form, you agree to the processing of your personal information by Westbank Community Health and Care for the purpose of this project (required)

YesNo

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