Apply for a Mindfulness course

    Please answer the following questions:

    Are you interested in learning practical ways of dealing with symptoms of anxiety or depression?
    YesNo

    Do you have a diagnosis of any of the following conditions; Schizophrenia, bipolar disorder, personality disorder, Obsessive Compulsive Disorder (OCD), Post-traumatic Stress Disorder (PTSD) or Social Anxiety?
    YesNo

    Are you in a crisis and need urgent help?
    YesNo

    Are you seeking support to help you manage uncontrollable anger?
    YesNo

    Do you have any visual impairments or difficulties with reading/writing that would impact on you attending the stress control course?
    YesNo

    Please complete the following information:

    Can we leave a voice message? (required):
    YesNo

    Can we send you text messages? (required):
    YesNo

    Can we contact you by e-mail? (required):

    Ethnicity (required):


    You must be registered at one of the surgeries above to be eligible for the course.

    Do you have a long term medical condition?
    YesNo

    Have you ever served in the armed forces or are a dependent of someone serving? (required):
    YesNo

    Are you (or your partner) pregnant or do you have caring responsibility for a child under 12 months? (required):
    YesNo

    We are sorry...

    Your responses to our questions have indicated that Mindfulness may not be the most appropriate treatment for you or that further information is required to identify the most suitable option.

    If you are experiencing anxiety and depression then Mindfulness may still be suitable for you. Please contact us on 01253 955700 or email bfwh.supporting.minds@nhs.net for further information.

    If you are receiving help from another mental health team, please contact them for more information rather than referring to us.

    If you are having thoughts about harming yourself or feel you are in crisis and need urgent help today please call 111 or:

    • Contact your GP and request an emergency appointment
    • Attend the Urgent Care Centre at Blackpool Victoria Hospital
    • SHOUT – free 24/7 text service for anyone in crisis anytime, anywhere. Text Shout to 85258
    • Phone the Mental Health Helpline on 0800 915 4640 (open Monday to Friday from 7pm until 11pm and from 12 midday to 12 midnight at weekends)

    If your main problem is alcohol or drug use, please contact Horizon https://www.horizonblackpool.uk/