Parental Mental Health and Child Welfare Network - Membership form

The Network is an opportunity to hear about practice developments, new research, publications and projects. It is an opportunity to share with others the work you are involved in as well as an opportunity to involve others in work you are hoping to take forward.

The Network will be a forum to debate local and national policy, training, management and practice dilemmas. It will also enable you to contribute to the development of national guidance.

Contact details
First Name
Last Name
Organisation
Address - line 1
Address - line 2
Town/City
County
Post Code
Telephone
Mobile phone
Fax
Email address
About you
Job title Please enter your job title in the box below.

Roles Please select the most appropriate role or roles from the list below (tick as many as apply).
Manager		Support Worker
Service user / Carer		Policy
Academic / Researcher		Other
Practitioner / Clinician
Interests What particular interest do you have in parental mental health and child welfare?

Participation Would you be interested in participating in focus groups or research about particular aspects of parental mental health and child welfare issues? (tick as many as apply)
Policy		Management
Practice Development		Research
Education and Training
Preferred method of contact (tick one only)
Email		Fax
Phone		Post
Mailing list From time to time we would like to send you email bulletins or newsletters with information about conferences, research and issues in parental mental health and child welfare. Please tick here if you do not want to receive this information. Your details will not be passed onto a third party.
Please see our Terms and conditions page for more information about data protection.

Photograph of family

Photograph of two children

Photograph of woman and child