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  • CONFIDENTIAL

  • Work Stress Solutions Registration Form

  • Personal Information

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  • Your Needs

  • We offer a range of free courses and support, subject to funding and availability. Please indicate which courses/support you would be interested in and we will place you on our waiting list and contact you as opportunities arise.

  • Agreement

  • Your signature indicates an understanding of this agreement with WSS and confirms you will follow the requirements below during your time with us.

    Therapy/Coaching/Course Attendance: I agree to attend regularly at the times agreed and contact the Coordinator with as much notice as possible if I am unable to attend. If I do not attend consistently this may affect my placement. Confidentiality: Personal and financial information remains strictly confidential, unless you consent to its use. Respect for the privacy of each participant/volunteer/beneficiary is guaranteed. Although there is a spirit of openness regarding health issues, your personal details will only be discussed where relevant and with your consent. If we have a concern about your well-being (particularly if you have not attended a course as expected and have not replied to our messages) we may contact your GP, Mental Health Professional/Organisation, Referrer or emergency contact and disclose or request information.

    Policies and Procedure: I agree to read and adhere to all WSS policies and procedures including Health & Safety, Equality & Diversity, Safeguarding Vulnerable Adults and Young People, Compliance and Data Handling Policy and Complaints Handling. I understand that copies of all WSS policies are available on the WSS website and in hard copy for reference purposes. Alcohol, Drugs, Smoking (or other alternatives) are not permitted at WSS venues.

    Reviews and Feedback: I agree to take part in reviews and provide and receive feedback on courses and the service provided. I agree for the information supplied on forms and from the measures completed to be used for audit and research. This information may be anonymously used to publish research articles; supply information/feedback for grants; or in publicity regarding our services. Employment: Funding for certain courses is dependent on employment status, so you need to advise us of any changes in your personal circumstances.

    Declaration: I give my consent for my comments to be quoted in WSS literature and on the WSS website for promotional purposes only anonymously on the basis that I will not be identified personally but as a participant, volunteer or beneficiary. I understand my name will not appear. I also understand that I can ask for my consent to be removed at any time.

    Additional Comments: I give consent to recieving emails(including newsletter, updates re-services/activities etc) and texts as required during my time with WSS. I am responsible for informing of any physical conditions that may affect my participation in physical/fitness activities to the Coordinator and instructor so they can tailor my support. I also give consent for my phone and or email to be passed on to facilitators supporting me or running any courses as required.

    We take responsibility of keeping personal information safe very seriously. If you are interested in knowing more about how we look after the information we process, you can find this in our General Data Protection Regulations (GDPR) Policy  in the Policies section of our website.

     

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  • Work & Social Adjustment Scale

  • People's problems sometimes affect their ability to do certain day-to-day tasks in their lives. To rate your problems, look at each section and determine on the scale provided how much your problem impairs your ability to carry out the activity. Circle the number at the start of the programme and put a cross at the end of the programme.

  • 0 indicates no impairment at all and 8 indicates very severe impairment

  • At the start of the programme.
  • For further information, Email: admin@workstresssolutios.org.uk, or Phone/text 07759303225.

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