North Kent Mind – Medway Digital Registration Form

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

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

Please note * is a required field.

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.