Thank you for taking the time to register for our Living with Secondary Breast Cancer face to face meetings.

We’re committed to providing people affected by breast cancer with the highest quality services and we need to have some information about you to make sure that this is the right service for you, meet any particular needs you may have and manage our relationship with you sensitively and appropriately.

We will use the information you provide in the way we’ve outlined above and (where relevant) in the ways we’ve outlined in the sections below. If you provide details about your health or other sensitive information, we will use it in the same way. If you no longer want us to use your information in these ways, you can get in touch using the contact details at the end of this form to discuss withdrawing your permission.

We will also use this information to provide our service and look at who attends, helping to make sure that our services are accessible to everyone and identifying any areas where we may need to improve. You will receive evaluation surveys to assist us in doing this.  Thank you so much for helping us.

Agreement

By ticking this box I understand and confirm that in providing information about myself and submitting this form, I give Breast Cancer Now my permission to store and use the information I provide for the above purposes.
About you
We need your email address in order to send you important information about this service.

We know that it can feel a little daunting attending a meeting for the first time.

You might have some questions about what the meetings are like and what people talk about in them.You might find it helpful to speak to our counsellor that facilitates these meetings before you attend for the first time. This will be a short phone call, an opportunity for the counsellor to introduce themselves and for you to ask any questions you may have.

Date of birth *
Date of most recent diagnosis (month and year) *
E.g., 2022-06-18
About your diagnosis

This service is for people with a secondary/metastatic diagnosis, please confirm this is your case.

Support
Online services

The event you are registering for is happening face-to-face, but we also offer online services for people living with secondary breast cancer. Please let us know if you would also like to register for them.

Other updates from Breast Cancer Now

We’d like to send you updates on our research, the support we provide, breast health information and our wider work to achieve our aims. We’d also like to tell you ways you can help us further, including by donating, fundraising, campaigning and volunteering. If you already hear from us, we will continue to contact you in the same way.

If you haven’t heard from us before now, please tick the box to show that you are happy to be contacted by:

How we use your information

From time to time, we may contact you by telephone and post about Breast Cancer Now, to keep you updated on our work and ways you can help. You can change the way you hear from us at any time by emailing us at supporterengagement@breastcancernow.org or calling us on 0333 20 70 300.

To help us to work more efficiently, we may analyse your information to make sure you receive the most relevant communications, and to target our digital advertising. This may include using publicly available information. You can ask us to stop this at any time, by contacting us using the above contact details. You can read more about how we will use your information in our Privacy policy.

Equality and diversity monitoring

Breast Cancer Now is committed to equality of opportunity for all. The following questions are not compulsory, but by giving us this information we can better meet our service users’ needs and make our services as accessible as possible.