North Kent Mind – Digital Registration Form

North Kent Mind is a registered charity (No1103790), who offer individuals who have previously suffered or currently suffering from a Mental Health issue support.

If you live in the Dartford, Gravesham, Swanley areas (if you live in the Medway area, please click here), please complete the form below.

Please note * is a required field.

(Do you look after, or give any help/support to family members, friends, neighbours or others because of either: •long-term physical or mental ill-health/disability? •problems related to old age?)
By ticking this box I agree to North Kent Mind's & LiveWell Kent Partner Privacy Promise (links below to policies).

Policies & NHS Numbers
(Please note all links below will open in a seperate window, already added form data will not be lost):

  • North Kent Mind Privacy Policy click here
  • North Kent Mind – Service-Users Code of Conduct click here
  • Live Well Kent Partners Privacy Promise click here
  • Information on how to find your NHS Number click here

Thank you for your self referral we will be in contact soon and may require some further information.