Order Request
After you fill out this order request, we will contact you to go over details and availability before the order is completed.
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Suicide and Self-harm Prevention Resource Tins
Are you ordering for the first time or replacing content *
What is the item/items you would like to order? *
Amount of Tins required *
Contact information
Please leave you contact information below so we can contact you with any relevant updates regarding your request
Name *
Company/ Address *
Job Title *
Area of your organisation *
Specific Locality *
Where will the tin be held?  *
Phone Number
Email Address *
Preferred contact method *
Required
Feedback!
Please leave any feedback you have on the tins or the specific resources within them! It really helps
Questions, comments and Feedback
Thank you! When you receive your order please email the email address bellow to confirm!
Please email Victoria Walker at: victoria.walker1@cntw.nhs.uk 
With any questions or queries 
Submit
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