Get Help Asking for help is the first and often the hardest step to take. We are here to help you the rest of the way. Full Name Email address Preferred Phone Number Permission to leave answerphone message? YesNo Other ways you might prefer to be contacted Gender I prefer not to sayMaleFemaleNon-BinaryOther Preferred pronouns I prefer not to sayShe/HerHe/HimThey/ThemXe/XemOther Age Location BodminBude/StrattonCallingtonCamborne/RedruthFalmouth/PenrynHayleHelstonLauncestonLiskeardLooeNewquayPenzanceSaltashSt AustellSt Blazey/ParSt IvesTorpointTruroWadebridge Language Any communication challenges and/or aids? How would you like us to help you? If not already mentioned, what physical or mental health needs do we need to be aware of? Describe anything else we need to be aware of before contacting you (?) The information I have provided is accurate and true to the best of my knowledge, and I consent to The CHAOS Group reaching out for further contact
