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Service User Network (SUN) Membership Form

SUN is a new, easy to access community-based service for adults experiencing difficulties with complex emotions often associated with personality disorder. Once the membership form is submitted a member of the SUN team will review and respond.

Please complete the form below to request membership to our service. Our terms and conditions can be found here

I agree to the terms and conditions

SUN Terms and Conditions

Membership details

First Name

Last Name

Date of Birth

Phone Number

Email Address

Confirm Email Address

House Name/Number

Post Code

NHS Number

You can obtain your NHS number using the find your NHS Number website

Gender

Ethnicity

Medical details

Do you have any medical conditions we may need to know about in an emergency (e.g. epilepsy, diabetes, allergies or asthma)?

Yes
No
I prefer not to say

What are these medical conditions?

Do you carry any medications with you for these conditions

Is there anything that you need from us to ease your access to the service?

Yes
No
I prefer not to say

Please indicate what you need to ease your access?

Emergency Contact Details

Full Name

Relationship

Contact Phone Number

​​​Service User Network (SUN) Membership Form

Please complete the form below to request membership to our service. Our terms and conditions can be found here

Membership details

Medical details

Emergency Contact Details

Service User Network (SUN) Membership Form