Skip to main content

Craigsfarm

Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
page
Facebook Instagram Linkedin Youtube
Menu
Menu
Donate Now
Book Now

Somatic Workshop Registration Form

    Somatic Workshop Registration Form

    All information given will be treated in the strictest confidence and stored in accordance with Data Protection legislation.







    Please answer all the questions and our Wellbeing Questionnaire [4 pages]. The following information will be helpful for the facilitator and help in planning around your needs.

    1. What part of your life is impacted by trauma [such as grief/chronic health/past events]? Does it affect your work, relationships, socialising?

    2. Do you have any trauma related triggers that you want the facilitator to be aware of or any questions about attending the workshop that you'd like to share with us?

    3. Is there anything you'd like us to know that might help us support your attendance (e.g., sensory needs, communication preferences)?

    PLEASE COMPLETE: Wellbeing Questionnaire

    IMPORTANT – PLEASE READ THIS FIRST

    This form has 10 statements about how you have been OVER THE LAST WEEK. Please read each statement and think how often you felt that way last week. Then select the option which is closest to this.

    Over the last week: I have felt tense, anxious or nervous

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I have felt I have someone to turn to for support when needed

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I have felt able to cope when things go wrong

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: Talking to people has felt too much for me

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I have felt panic or terror

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I made plans to end my life

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I have had difficulty getting to sleep or staying asleep

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I have felt despairing or hopeless

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: I have felt unhappy

    Not at allSeveral daysMore than half the daysNearly every day

    Over the last week: Unwanted images or memories have been distressing me

    Not at allSeveral daysMore than half the daysNearly every day

    The information collected on this intake form is confidential and is reviewed only by our team to help us create a safe and supportive environment.

    Declaration: I confirm the above information is correct. I understand it is my responsibility to:

    • If relevant, check with my doctor if I have difficulties about my ability to participate in this support

    All personal information will not be shared or sold and will be for the sole use of Craigsfarm Community Hub. I give permission to Craigsfarm Community Hub to use photographs obtained during classes, workshops and events to use as part of a public display which may include Craigsfarm Community Hub website and other print publications.

    Data Protection: Craigsfarm Community Hub complies with data protection law in the UK and laws in other countries that meet internationally accepted standards. You have the right to ask for a copy of the information we hold on you, and the right to ask us to correct any inaccuracies in that information. If you have concerns about how we have used your personal information, you also have the right to complain to a privacy regulator. For detailed information, contact us on info@craigsfarm.org.uk for a copy of our Privacy Policy.





    I would like to receive information and updates on Craigsfarm Community wellbeing + resilience programme activities and Craigsfarm events


    Thank you for completing this form

    Join Our Community

    The work of the Craigsfarm Community Development Project is made possible through the commitment of our team, partners, and community members. If you would like to learn more about our programmes, get involved, or access support, we welcome you to connect with us and become part of the Craigsfarm community.

    Contact Us