Younger Women with Secondaries Together in person sign up - Bristol

Thank you for taking the time to register for our Younger Women with Secondaries Together face-to-face event. To book a place, please complete all fields in the form below and press submit.

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 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.

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
About you
Phone number type
Can we say we are from Breast Cancer Now if someone else answers the phone?
Can we leave a voicemail if there is no answer?
Your address
Add your postcode below to find your address.
Enter address manually

We are asking the following questions to help our facililators tailor the meeting experience to your needs.

Do you have any children
About your diagnosis

The Younger women with secondary breast cancer service is for people with a diagnosis of secondary breast cancer.

Secondary breast cancer is breast cancer that has spread beyond the breast and lymph nodes under the arm, to other parts of the body such as the bones, lungs, liver, or brain. It may also be referred to as metastases, advanced breast cancer, secondaries, or stage 4 breast cancer.

About the event

During our sessions, we host breakout groups to discuss a topic in more detail.

Please select your preference order for each session.

Breakout group 1
Adjusting/adapting to a life-limiting illness
Supportive care
Relationships and communication
Wellbeing sessions

Please select your preference order for each session of this group.

Laughter workshop
Exercise
Breakout group two

Please select your preference order for each session of this group.

Talking with/supporting children
Adjusting/adapting to a life-limiting illness
Intimacy and sexuality
Attending the event
Support
Do you need any additional support in order to access the service?
We provide overnight accommodation for the Friday night. If you would rather not stay over please let us know in advance.
If applicable would you be able to evacuate the building without assistance/independently in the rare event of an emergency?
Emergency contact details
Participant information

Please read this carefully before agreeing to the statements below.

• We expect everyone using and attending our services (staff, volunteers and participants) to show each other due consideration, respect and understanding and to follow the ground rules agreed at each event

• All our services are free. All we ask of you is to attend and fully commit to the whole programme

• If you are no longer able to attend please let us know as soon as possible so that your place can be offered to someone else

• The number of participants in each breakout group is limited so that everyone gets enough time to share and contribute as fully as possible. We will do our best to give you your first choice, however sometimes it may not be possible to do this for every session

• Please contact us in advance if you think you would like to change your group and we will try to accommodate your request, as this will not be possible on the day

• We cannot provide medical treatment. If medical treatment is required, we will contact the appropriate services and your emergency contact. If you have any concerns about your condition or treatment in advance of attending, please check with your medical team

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.

Do you consider yourself to be disabled?

Everyone affected by breast cancer can turn to us for support. So, we want to make sure that no one faces any barriers when using our services.

If you’re disabled and would like to use one of our services, we’ll do everything we can to make sure they’re accessible to you. Find out how we make our services accessible.

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