Register interest in our next online programme, open to new mothers nationwide experiencing low mood, feelings of stress, anxiety and social isolation with babies aged 0-12 months.

Please note our next online programme will be late September to December 2026. Babies will need to be aged 0-12 months at the start of the programme.

Completing this form is the first step to attending a Breathe Melodies for Mums programme. Once submitted, you will hear from one of our team who will be able to provide guidance on next steps as well as answer any questions you may have.

If you require help completing this form or would like to receive it in a different format please contact us on [email protected].

We look forward to hearing from you!

Personal Details


All fields are mandatory, please complete the form in full to ensure your registration is processed as quickly as possible.

Mother's Full Name: Mother's Age: Mother's Date of Birth: What gender do you identify with? Which language do you speak mostly at home? What is your ethnicity: Baby's Date of Birth (Please note to be eligible for this programme your baby must be aged 12 months or younger at the start of the programme): Baby's name: Email: Confirm email: Telephone: Postcode: UK Region of Residence: (select from dropdown)
Recruitment Method: (select from dropdown) Other, Please Specify: Do you have any access or support needs to ensure you can take part in this activity? (E.g. wheelchair access, captioning for online activity, large print information, sign language interpretation) If you answered yes to the question above, please give detail below:

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