Consent Statement : "Any personal information you provide will be held in accordance with the General Data Protection Regulation (EU) 2016/679 and used for processing your attendance on the programme. We will share your data with Brio Wellbeing, Cheshire West and Chester Council (commissioner of the service) and your Healthcare Professional. Are you happy to proceed?"
Before submitting this form, please check if you or a person you are referring is eligible for Go Smoke Free service. Our programme is designed for current tobacco smokers aged 12+ who are Cheshire West residents. We cannot accept referrals for anyone who has already stopped smoking and/ or interested in stopping vaping.