Go Active Get Healthy Logo
Enquiry Form

About you

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Day
Month
Year

How to contact you

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e.g. an interpreter for foreign language or for BSL/Deaf interpreting

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e.g. Mon-Wed 9am-1pm

Informed Consent

The information you provide on this enquiry form will only be used to administer your interest in joining GO Active Get Healthy - Diabetes. The District Council and Active Oxfordshire are the joint data controllers of the information you provide, and are processing this data, contractually, in order to provide this service to you. GO Active Get Healthy - Diabetes will use your information in accordance with the UK GDPR and UK DPA 2018.

We will share your information with the District Council who is responsible for providing support and signposting to meet your physical activity needs as part of GO Active Get Healthy - Diabetes. Information that you enter on this form will be sent directly to the GO Active Get Healthy - Diabetes team to contact you and get started. Your data will be collected electronically or on paper and stored safely in a secure database.

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The GO Active Get Healthy - Diabetes team would like to contact you to provide advice and guidance to take part in physical activity, including regular follow ups to offer ongoing support.

Please be aware that you have the right at any time to withdraw this consent and to stop us from contacting you. If you would like to do so, please contact the GO Active Get Healthy - Diabetes district coordinator.

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We would like to share your anonymised* data with our evaluators, Shepherd & Moyes, for long-term monitoring and evaluation purposes. This information may be used to demonstrate the impact of GO Active Get Healthy - Diabetes and inform future improvements.

The personal information you provide will be held for a period of 12 months following your last known contact with GO Active Get Healthy - Diabetes, after which it will be securely destroyed. You have the right to the access and removal of personal data concerning you.

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* anonymised: where any information that could lead to an individual being identified has been removed

Optional Questions

This section of the form is completely optional. Filling it out will help us monitor and improve GO Active Get Healthy - Diabetes.

Please contact support@oxfordcodelab.com if you experience any problems with this form.
All data will be processed in accordance with our privacy policy.