Working for Health is an employment support service, for more information about us, please visit www.workingforhealth.co.uk.

Please complete all sections of this form. If there is any information missing, we may need to contact you by telephone, and this may delay enrolment and support.

Some of our programmes require people to meet certain eligibility criteria. Please check the relevant boxes so that we can assess which programme you / they may be eligible for. Thank you.