for better mental health

1 of 1 YOUR DETAILS

Application for focus group to Help make Mind’s media work representative

Selection will be based on demographic information provided and your responses to the questions.

Please refer to the the main page whilst completing this form. 

If you identify as being Mixed Black and Asian you are welcome to apply for both groups, provided that you are able to share different thoughts in each group. Please tick both boxes if this is the case for you.


If you identify as being Mixed Black and Asian you are welcome to apply for both groups, provided that you are able to share different thoughts in each group. Please tick both boxes if this is the case for you.

By ticking the above box(es), you are confirming you are able to attend.










Please refer to the list on the main page (you might want to open it in a separate window) to find out what we're looking for and what you’ll have a chance to share about.
Please refer to the list on the main page (you might want to open it in a separate window) to find out what we're looking for and what you’ll have a chance to share about.
If yes, please provide more detail in the box below.
If yes, please provide more detail in the box below.

How would you describe your ethnic background?

Please select all that apply.








Please select all that apply.

If you change your mind about participating in this research, you can stop at any time.

We are collecting this data for the purpose of the project work to make Mind’s media work representative, only.

We take your privacy seriously and promise to never sell your data. We will use the information you have provided to administer your application. Once you have applied, we will contact you about your application. You can find out more about your rights, how we use your personal information and how we keep your details safe and secure by reading our privacy policy.

For more information or to withdraw your consent to us processing your data, contact our Supporter Relations team at [email protected] or on 020 8215 2243.

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