Sign Up Form – ICS Staff Wellbeing Workshops Winter 2022

Breathe Dance for Mind and Body (in person)
Breathe Drawing for Unwinding (online)
Breathe Song and Sound Journey for Relaxing (online)

How did you hear about Breathe’s Arts for Staff Wellbeing Programme? (select from dropdown) Staff Bulletin Email Whatsapp Poster Through a Colleague Intranet Directly through Breathe Other If you answered 'Other' to the question above, please specify: Are you a health care or social care worker? Health Care Social Care Which South East London ICS trust do you work within? (e.g. SLaM, GSTT, Lewisham & Greenwich) 

What is your role?

Which department do you work within?

  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) yes no If you answered 'Yes' to the question above, please give details:

Check this box if you would like to hear about exciting new taster sessions such as live music, visual arts, poetry and more!
Yes please!
If there is a new artform you would like to see, have your say below. We’d love to hear your suggestions:

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