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Register Form

Please fill in your details below.

Signing up and providing us with your details means you are agreeing to be contacted by ourselves.
Pain Association Scotland takes your privacy seriously and will only use your personal information:

· To provide you with information on the Association’s services.

· To improve our service and to contribute to research into chronic pain.

Under GDPR the details are for our records and therefore won’t be shared with anyone else.

A full copy of the policy can be found on our website.

* PLEASE NOTE THAT FOR ONLINE SESSIONS WE WILL EMAIL YOU THE ZOOM LINK AND ANY NOTES FROM THE SESSIONS. SO PLEASE CHECK YOUR JUNK INBOX* PLEASE LET US KNOW IF YOU DON'T WISHED TO BE CONTACTED.

*PLEASE NOTE THAT YOU HAVE TO LIVE IN THE HEALTH BOARD TO ATTEND THE MEETINGS*

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* 1. Please select a group from the drop down menu in the next question. Please note that some group meetings are online only and some are a blended model of face to face and online.

*PLEASE NOTE THAT YOU HAVE TO LIVE IN THE HEALTH BOARD TO ATTEND THE MEETINGS*

Signing up and providing us with your details means you are agreeing to be contacted by ourselves.

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* 2. Which group will you attend?

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* 3. Title

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* 4. Full Name

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* 5. Address

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* 6. Phone Number

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* 7. Email Address

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* 8. Date of Birth

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* 9. Who were you referred by

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* 10. Please give details of who referred you and their address if you know it.

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* 11. If there is an issue with the meeting and we need to let you know, please select your preferred method of contact.

0 of 11 answered