Sign up below for our FREE 10-week programme, open to new mothers living in the London Borough of Wandsworth experiencing low mood, feelings of stress, anxiety and social isolation with babies aged 0-9 months.

Sessions start on Thursday 5th October 2023 for 10 weeks.

Please note these programmes are open to residents of the London Borough of Wandsworth only.

Completing this form is the first step in expressing your interest to attend a Breathe Melodies for Mums Programme. Once completed, you should expect to hear from one of our team within two working days. They will be able to provide guidance around the next steps in signing up to attend the programme as well as answer any questions you may have.

If you require any help completing this form or would like to receive it in a different format please contact us by email on or telephone 07511 214 069.

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: Confirm Mother's Full Name: Mother's Date of Birth: Baby's Full Name: 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 Gender: Email: Confirm email: Telephone: I live in the London Borough of Wandsworth (please tick): Yes
House number & Street: City: Postcode: Confirm Postcode: Country:
Emergency Contact Full Name: Emergency Contact Number: GP's Name: GP Practice: City: Postcode: Country: GP's Contact Number: Session Preference:(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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