Hopespace

Evening group offering opportunities to socialise and receive wellbeing support and guidance.

What is Hopespace?

Hopespace is an evening group in central Bath. The group meet in a comfortable and warm setting and enjoy conversation, games, quizzes and fun. Hopespace is supported by Bath Mind staff and volunteers to offer mental health and wellbeing support and guidance, as well as signposting to other services where necessary.

When: Tuesdays from 6pm – 8pm
Where: The Bubble, St John’s (Chapel Court, Bath, BA1 1SQ)
Cost: £2 per session

Hopespace is open for self-referrals! To join the Hopespace group, please complete our online referral form, or contact our Wellbeing team on the details below.

Tel: 07538 113890

Email: [email protected]

Self-refer here

Can you get to the group on your own? *

Coming to a group for the first time can be nerve racking, do you feel able to give it a try? *

Have you looked at all the groups we offer, which interests you the most? *

Crafty Minds
Football Group
Food For Thought
Greenlinks
Hope Space
Open Opportunities
Radstock Group
Safe Space Youth Group
Sports Group
Wellbeing Walking Group
Unsure - please advise me what would suit me best

Is there anything staff can do to help you get through the door and join a group? Please share this with staff if you decide to make contact.

Referral made by: *

Self
GP
Other professional - please give details

Other professional details

Title *

First Name(s) *

Surname *

Preferred Name/Name like to be known as

This could be a nickname you prefer, or an additional name you may like to go by.

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Landline

Mobile

Can we contact you by the following means? Please tick all that apply *

Text
Phone
Email
Post

Information About You

Have you been known by any other name, or do you work with any other services that know you by any other names? If so, please let us know.

Date of birth *

Gender *

Male
Female
Non-Binary
Prefer not to say
Other (please specify)

Your Pronouns

He/him
She/her
They/them
Other (please specifiy)

Pronouns are used in place of a proper noun (like someone’s name). We use pronouns most often when referring to someone without using their name.

How would you describe your relationship status? *

Single
Married
Co-Habiting
Civil Partnership
Divorced/Civial Partnership Dissolved
Separated
Registered Partnership
Don't Know
Prefer not to say
Other (please specify)

If Other, please specify:

First Language

Ethnicity

What is your employment status?

Employed (Full time)
Employed (Part time)
Voluntary Work
Unemployed (Long term sick or disabled)
Unemployed (looking for work)
Full time student
Part time Student
Retired
Other

If part time, how many hours do you work in a typical week?

Do you receive benefits?

If so, which ones?

Attendance Allowance
Carers Allowance
Child Benefit
Disability Living Allowance
Employment and Support
Housing Benefit
Income Support
Jobseekers Allowance
Pension
PIP
Maternity Pay
Universal Credit
War/Widower Benefits
Other
Prefer not to say

Do you have a carer?

Are you a carer for someone?

Are you a care leaver?

Do you consider yourself disabled?

If so, please describe your disability. You may select more than one.

Physical Condition (such as a substantial or long-term condition affecting a part of a person’s body that impairs and limits their physical functioning, mobility, stamina or dexterity includes using a wheelchair or crutches)
Sensory Condition (such as when one of your senses; sight, hearing, smell, touch, taste and spatial awareness, is no longer normal)
Mental health condition, (such as depression or anxiety)
Learning disability/difficulty (such as Down’s syndrome or dyslexia)
Cognitive condition (such as autistic spectrum disorder)
Long-standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy
Prefer not to say

How do you hope coming to a group will help you? *

Connect and reduce loneliness
Be more active
Try a new activity
Better manage my mental health
Other (please state below)

Please state what other help you may be looking for

Currently registered with or receiving support from any other service?

If yes, please provide further information on that service

Information about your GP/Surgery

GP Practice you are currently registered with

Name of your GP

Emergency Contact Details

Full Name

Phone Number

GP Email

Relationship to you

In case of an emergency, do you give us permission to discuss your records with them?

Is there any other relevant information you would like us to know? *

Would you like to sign up to receive monthly updates from Bath Mind including wellbeing tips, upcoming events and courses, and charity news? *

CONFIDENTIALITY & DATA PROTECTION

Bath Mind is committed to maintaining client confidentiality. All information about you is held securely and not shared with anyone outside our organisation without your permission, or unless exceptional circumstances occur. If you wish to see the records we hold about you this can be arranged by request to the Chief Executive Officer of Bath Mind. If we believe there is a risk of harm to you or someone else we will inform the appropriate person (such as your GP or other health professional), but we would always endeavour to discuss this with you in advance.

For further information please view our Privacy Policy

Declaration
I understand and have read, Bath Minds Privacy Policy. I declare that the information provided by me is accurate to the best of my knowledge.

If I choose to go ahead and access the services provided by Bath Mind, I hereby authorise Bath Mind to store personal information related to me and the service I receive.

If you are happy to accept the above terms and conditions please tick the following box and click on the button marked submit.

Single Checkbox Field *

I am happy to accept the above terms and conditions.

Hopespace

What is Hopespace?

To view our upcoming wellbeing courses and workshops, head to our events page!

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Hopespace

What is Hopespace?

To view our upcoming wellbeing courses and workshops, head to our events page!

Your cart is empty.