Aplos Health & Wellbeing Journey - September 2026 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.

Question Title

1. How did you find out about this programme?

I received an e-mail about the programme

I received a text message about the programme

I found out about the programme another way

The practice nurse told me about the programme

My GP told me about the programme

Please tell us how you found out about the programme ...

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2. Your first name (Required.)

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3. Your surname (Required.)

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4. Your mobile phone number (please leave a space after the first 5 digits) (Required.)

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5. Your e-mail address (Required.)

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6. Which GP practice are you registered with? (Required.)

The Vale Medical Centre

Woolstone Road Medical Centre

Wells Park Practice

Sydenham Green Group Practice

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7. Please select your preferred time for doing the 12 workshops
(Required.)

Tuesdays 10-11am (starting 22nd September 2026)

Tuesdays 6-7pm (starting 22nd September 2026)

Aplos Health & Wellbeing Journey - September 2026 course

Question Title

* 1. How did you find out about this programme?

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* 2. Your first name (Required.)

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* 3. Your surname (Required.)

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* 4. Your mobile phone number (please leave a space after the first 5 digits) (Required.)

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* 5. Your e-mail address (Required.)

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* 6. Which GP practice are you registered with? (Required.)

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* 7. Please select your preferred time for doing the 12 workshops (Required.)

1. How did you find out about this programme?

2. Your first name (Required.)

3. Your surname (Required.)

4. Your mobile phone number (please leave a space after the first 5 digits) (Required.)

5. Your e-mail address (Required.)

6. Which GP practice are you registered with? (Required.)

7. Please select your preferred time for doing the 12 workshops
(Required.)