Thank you for your interest.

Please note, Breathe Sing for Lung Health is only open to former and current patients of Guy’s and St Thomas’ NHS Foundation Trust.

We look forward to welcoming you.

Personal Details

Fields marked with * are mandatory.

*First name/s: *Surname: *Mobile number: *Email: *Confirm email: *Have you experienced any of these lung conditions (Asthma, Bronchiectasis, Chronic Obstructive Pulmonary Disease (COPD), ILD/ IPF, Breathlessness following hospital stay).
Please select Yes or No from the dropdown. Please tell us your lung diagnosis? (e.g. COPD, IPF): *Are you a current or former Guy's and St Thomas' patient? Please select from the dropdown.
*Please provide Emergency contact information (should anything happen to you at Breathe Sing)
Emergency contact Name: Emergency contact Telephone: What is their relationship to you? *How did you first hear about Breathe Sing? (select from dropdown) If you selected Other, please say where: 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:

I agree to Breathe Arts Health Research occasionally taking screenshots or short recordings of online sessions for promotional and reporting issues. (No personal details will be visible).

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