Online Interventions | The Centre Place

An online course providing:
Understanding – Learn what anxiety is, the causes, and the effects on the body and mind.
Recognition – Identify physical and emotional signs of anxiety.
Reduction Techniques – Discover and practice strategies to reduce anxiety in daily life.

Whether you’re a young person seeking tools to manage anxiety — or a parent/carer looking to offer support — this course provide valuable knowledge and practical skills to build resilience and confidence.

To book a place on Anxiety Freedom, please complete the referral form below. Once submitted, we will book you onto the next available session.

If you have already referred and are awaiting an appointment, you do not need to submit another referral. Please contact the office on 01909 479191 to book your place.

Online Interventions

Consent

UK Data Protection Laws requires our organisation to manage all personal information in accordance with the General Data Protection Regulations. In particular, we are required to process your personal information fairly, lawfully and in a transparent manner. This means that you are entitled to know how we intend to use any information you provide. You can then decide whether you want to give it to us in order for us to provide the service or services that you require.

In accordance with GDPR all of the information we request and collect is for the legitimate purpose of accessing our services. All contact information will be used to contact you with details of service and or services that you have requested. Your personal details will not be retained for any other purpose.

All of our staff are responsible for maintaining your confidentiality. As an organisation we provide training to all members of staff and ensure that they are aware of their obligations. In addition to this our policies and procedures are regularly audited and reviewed.

If you would like to update the information we hold for you, change the methods by which you would like us to contact you or if you would like to have your information removed from our records please contact us at info@centreplace.org.uk or write to us at The Centre Place, Abbey Street Community Centre, Abbey Street, Worksop, S80 2LA

Young Persons declaration:

• I give consent for The Centre Place - Talkzone Mental Health Service to share my details with relevant professionals /organisations to help the Talkzone service to give me accurate and appropriate support.

• I agree that information provided will be stored on a secure database for a minimum of 7 years and to be used anonymously for monitoring purposes.

I agree.

What session are you booking onto?

Anxiety Freedom

Full Legal Name

Preferred/Chosen Name

If different from above.

Birthday

Dzień

Miesiąc

Rok

Multi-line address

Kraj/region

Adres

Miejscowość

Kod pocztowy

Email

The link to the join the online group will be sent to this email address.

Phone

Gender Identity

Is your gender identity the same as the one assigned at birth?

Yes

No

Prefer not to say

Preferred pronouns

Sexual Orientation

How best describes your Ethnicity /Ethnic origin

Are you part of any Religious Group?

Employment status

Accommodation Status

Name of GP Practice

Address of GP Practice

Emergency Contact Information

Name of Emergency Contact

Phone Number of Emergency Contact

Do we have permission to contact your emergency contact?

Yes

No

If you are under 16 years of age, we cannot process the referral without consent to contact someone in case of emergency. In safeguarding situations, if you are under the age of 16 we will be required to contact your parents or carers.

Thank you for your referral. You will receive an email with details of the next session with the link to join the meeting which will be on Microsoft Teams. If you require any other support, such as 1-1 counselling or mental health and wellbeing support please complete the FULL referral on our website.