CLDF Young People’s Support Service Form

As CLDF is a UK registered Charity, please only complete this form if you live in the UK.

Name & Details of Young Person with a Liver Condition (aged 16-24)















Young Person's Health Information










Please Give Us Your Consent



Tell Us How You Want To Hear From Us

Children's Liver Disease Foundation (CLDF) would love to keep in touch with you about our vital work. By contacting you in the way you choose, we can be more cost effective in our communications and marketing activity. Please let us know what you would like to hear from us about and how by ticking the box(es) below. You can choose all these options or just one or two of them-it's up to you.
*Please note you will only ever be contacted by phone by a member of the CLDF team.

By postBy emailBy phone*By text/SMSAll of the above

By postBy emailBy phone*By text/SMSAll of the above

We have two fantastic residential opportunities - please let us know below if you would like more information.

YesNo

YesNo

Your Details Are Safe With Us

We'll always store your personal details securely. We'll use them to provide the service(s) that you have requested and communicate with you in the way(s) you have agreed to. Your details may also be used for analysis purposes, to help us provide the best possible service. We won't sell your details to anyone else and we'll only share them with suppliers working on our behalf, or if required to do so by law. For full details please CLICK HERE to view CLDF's Privacy Notice. We suggest that you read this Privacy Notice to understand what information we hold, how we use it and what your rights are.


Any Other Information