circles sign up form

What is your connection to pancreatic cancer?(Required)

We ask for your connection to pancreatic cancer so we can understand more about who is using our services

How long ago was the diagnosis(Required)

We ask for your connection to pancreatic cancer so we can understand more about who is using our services

Which groups would you like to join?(Required)

I am currently living with pancreatic cancer - WhatsApp
I am currently living with pancreatic cancer - Facebook
I can have surgery - WhatsApp
The 3am Club - WhatsApp
Cookery, Nutrition and Recipe sharing - WhatsApp
Moments of Joy - WhatsApp

Which groups would you like to join?(Required)

Family, Friends, Carers' Group - WhatsApp
Family, Friends, Carers' Group - Facebook
The 3am Club - WhatsApp
Cookery, Nutrition and Recipe sharing - WhatsApp
Moments of Joy - WhatsApp

Phone number for WhatsApp Groups only

Please note that if you choose to join a WhatsApp group, your phone number will be visible to other group members

How did you hear about Circles?

What do you hope to get out of the group/s?(Required)

Your confidentiality, privacy and safety

Safeguarding and Group Guidelines(Required)

I agree to the Safeguarding and Group Guidelines

We would like to keep your details so that we can monitor and improve our services. Are you happy for us to keep your details for these purposes?(Required)

Yes, I’m happy for Pancreatic Cancer UK to record my information to help monitor and improve their services
No, I do not want my information recorded for the purpose of monitoring and improving Pancreatic Cancer UK’s services

Privacy policy

By registering for Circles via this form, you are agreeing for Pancreatic Cancer UK to add you to a group/s via WhatsApp (via your phone number provided) or Facebook (via your email address provided).

You can leave these groups at anytime, without notice. See our privacy policy.

If you give consent to record your details to our improve services, we will use the information you have provided to create a confidential record so that we can monitor and improve our services. See our privacy policy.

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Name

This field is for validation purposes and should be left unchanged.

Sign up to Circles

This service will allow you to connect to others currently affected by pancreatic cancer via groups. Share the highs, the lows and everything in between with people who understand, who ‘just get it’.

Step 1 of 2

About you

Your confidentiality, privacy and safety

Sign up to Circles

This service will allow you to connect to others currently affected by pancreatic cancer via groups. Share the highs, the lows and everything in between with people who understand, who ‘just get it’.

Step 1 of 2

About you

Your confidentiality, privacy and safety

Sign up for email updates