Aplos Health & Wellbeing Journey - February 2025 course

Submission of this form will tell us which course of workshops you would like to join on Zoom. All the information will be used only within Aplos PCN. We will not share this information with any third party for any purposes.
1.How did you find out about this programme?(Required.)
2.Your first name(Required.)
3.Your surname(Required.)
4.Your mobile phone number(Required.)
5.Your e-mail address(Required.)
6.Which GP practice are you registered with?(Required.)
7.When did you last think about making changes for looking after your health?(Required.)
8.How do you feel about committing to attending at least 6 of the 12 workshops?(Required.)
9.Please select your first choice of time for doing the 12 workshops(Required.)
10.Please select your second choice of time for doing the 12 workshops(Required.)
11.Have you had a cholesterol or blood sugar test done by your GP in the past 12 months?(Required.)
12.Would you be happy to come in for a cholesterol and blood sugar test if you haven't had one within the past 12 months?(Required.)
13.By how much has your weight changed over the past 12 months?(Required.)
14.What is your current weight?(Required.)
15.What is your height?(Required.)