I am not a GMMH employee * If you are a GMMH employee you already have access to the recovery academy via the Learning Hub, you can login directly to Learning Hub to access Recovery Academy courses.

Work email address

First name *

Surname *

City/Town *

Date of Birth

NI Number * This information will be kept confidential and not shared with anybody. It is required to prevent duplication of student accounts as everyone's NI Number is unique.

Address *

Postcode *

Contact Number *

Which option best describes you * Please Select... I am under the care of mental health services in Bolton I am under the care of mental health services in Central Manchester I am under the care of mental health services in North Manchester I am under the care of mental health services in Salford I am under the care of mental health services in South Manchester I am under the care of mental health services in Trafford I am under the care of mental health services in Wigan I am under the care of Child and Adolescent Mental Health Services (CAMHS) I use Primary Care Psychological Therapy Services (often referred to as IAPT) I use Specialist Community Psychological Therapy Services (e.g. Military Veterans Service, Eating Disorder Service, Perinatal Community Mental Health Team) I use Health and Justice Services I am a patient in Adult Forensic Services I am a patient in Rehabilitation Services I am a patient in the Mental Health and Deafness Unit (John Denmark Unit) I use Addiction Services I support someone with mental health/addiction difficulties as a friend or family member I am a professional who works in the voluntary sector I am a professional who works in the statutory sector I am a professional who works privately for myself/private organisation Student Other Background Information – Strictly Confidential (Monitoring Purposes Only)

Special Requirements Do you have any special requirements that you think we should be aware of e.g. special needs, large print course materials, disabled access, requirement for one to one support help to define long term goals?

If ticked above, please specify

Are you * Please Select... Male Female Prefer not to say Prefer to self-describe Monitoring Information – Strictly Confidential (Optional)

If selected prefer to self-describe above

Do you consider yourself to have a physical or mental health condition or disability? Please Select... No Yes

If you selected yes above

Which of the following best describes your ethnic background? * Please Select... Asian or Asian British – Bangladeshi Asian or Asian British – Pakistani Asian or Asian British – Indian Asian or Asian British – Any other Asian background Black or Black British – African Black or Black British – Caribbean Black or Black British – Any other Black background Mixed – White & Asian Mixed – White & Black African Mixed – White & Black Caribbean Mixed – Any other Mixed background White – British White – Irish White – Any other White background Other Ethnic Group – Chinese Other Ethnic Group – Any other Ethnic group I do not wish to disclose this

Contact Preferences * Email Post Phone Text Message Any
Account authorisation, booking requests and webinar information will be sent via email. Are we able to contact you via any other means?