Healthcare Professional Contact Form We support working age stroke survivors and their families across the UK, and we’d love to stay in touch. Please complete this short form to request information, resources, or to connect with our team. Your Details:Name(Required) First Last Job TitleOrganisation / Hospital / TrustAddress(Required) Street Address Address Line 2 City County Post Code Email(Required) PhoneStay in Touch:How would you like us to keep you updated? (select all that apply): Receive email updates about Different Strokes Receive twice-yearly printed newsletter Order Resources:I would like to order the following: Children’s Resource Pack Information Pack Leaflet Selection Details on the nearest local group Details on the Black and Asian Stroke Survivors Project Information on the Physio Bursary Someone to contact me Please share any specific questions, feedback, or information requests below:Consent(Required) I consent to Different Strokes storing and using my information to respond to my enquiry and send relevant updates. Δ
