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Register for a Moving Forward online course

Thank you for taking the time to register for our Moving Forward online course.

We’re committed to providing people affected by breast cancer with the highest-quality services. We need to have some information about you to make sure this is the right service for you, meet any particular needs you may have, and manage our relationship with you sensitively and appropriately.

We will use the information you provide in the way we’ve outlined above and (where relevant) in the ways we’ve outlined in the sections below. If you provide details about your health or other sensitive information, we will use it in the same way. If you no longer want us to use your information in these ways, you can get in touch using the contact details at the end of this form to discuss withdrawing your permission.

We will also use this information to provide our service and look at who attends, helping to make sure that our services are accessible to everyone and identifying any areas where we may need to improve. You will receive evaluation surveys to assist us in doing this. Thank you so much for helping us.

User agreement *
About the event
About you
Phone number type
Can we say we are from Breast Cancer Now if someone else answers the phone?
Can we leave a voicemail message if there is no answer?
Your address
Add your postcode below to find your address.
Enter address manually
About your diagnosis

Our Moving Forward courses are for people who have had a primary breast cancer diagnosis. Primary breast cancer is breast cancer that hasn’t spread beyond the breast or the lymph nodes (glands) under the arm.  This includes DCIS (ductal carcinoma in situ). 

You can also attend Moving Forward if your breast cancer has cancer come back in the chest, breast or armpit area, or in the skin near the original site or scar (local recurrence) or have a new primary breast cancer.

I have had/have primary breast cancer/DCIS
I have had/have a local recurrence
Have you finished your active treatment (e.g any chemotherapy or radiotherapy)?
Support
Do you need any additional support to access the service?
Participant information

Please read this carefully before agreeing to the statements below

We expect everyone using and attending our services (staff, volunteers and participants) to show each other due consideration, respect and understanding and to follow the ground rules agreed at each event.

All our services are free. All we ask of you is to attend and fully commit to the whole programme.

If you are no longer able to attend please let us know as soon as possible so that your place can be offered to someone else.

Participant agreement *
Keeping in touch with Breast Cancer Now

We’d like to tell you about ways you can help further, including through donating, fundraising, campaigning and volunteering. And we'd like to send you updates on our research, the support we provide, breast health information and our wider work to achieve our aims.

If you already hear from us, we will continue to contact you in the same way. If you don’t already hear from us, please tick the box if you are happy to be contacted by:

How we use your information

From time to time, we may contact you by telephone and post about Breast Cancer Now, to keep you updated on our work and ways you can help. You can change the way you hear from us at any time by emailing us at hello@breastcancernow.org or calling us on 0333 20 70 300.

To help us to work more efficiently, we may analyse your information to make sure you receive the most relevant communications, and to target our digital advertising. This may include using publicly available information. You can ask us to stop this at any time, by contacting us using the above contact details. You can read more about how we will use your information in our privacy policy.

Equality and diversity monitoring

Breast Cancer Now is committed to equality of opportunity for all. The following questions are not compulsory, but by giving us this information we can better meet our service users’ needs and make our services as accessible as possible.

Do you consider yourself to be disabled?

Everyone affected by breast cancer can turn to us for support. So, we want to make sure that no one faces any barriers when using our services.

If you’re disabled and would like to use one of our services, we’ll do everything we can to make sure they’re accessible to you. Find out how we make our services accessible.

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