The information you provide to us will be recorded on a case management system. All information is securely and safely stored with controlled access to only those who need to see it.

Your personal information is important to us and we will keep it confidential within Cranstoun and stored in line with the Data Protection Act 2018 and UK GDPR. We have a Privacy Policy that you can read here or alternatively you can request a copy from us.

There are occasions where we may need to share your information with partner agencies to ensure you receive the support and advice that you need. We will discuss and agree this with you first. If we have any concerns around your safety and wellbeing, we may need to share your information with the appropriate agencies such as safeguarding teams without your consent. We will always try to discuss this with you before we share your information with others.

Talk to a hub worker if you have any questions. Anonymised data and reports will be provided to the funders to evidence and demonstrate the work of ROUTES.

First name (Required)

Surname (Required)

Date of birth (Required)

Contact number

Email

Would you like to be contacted about upcoming groups and activities?
—Please choose an option—YesNo

Gender

Ethnicity
—Please choose an option—Asian or Asian BritishIndianPakistaniBangladeshiChineseAny other Asian backgroundBlack, Black British, Caribbean or AfricanCaribbeanAfricanAny other Black, Black British, or Caribbean backgroundMixed or multiple ethnic groupsWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed or multiple ethnic backgroundWhiteEnglish, Welsh, Scottish, Northern Irish or BritishIrishGypsy or Irish TravellerRomaAny other White backgroundOther ethnic groupArabAny other ethnic group

House number (Required)

Postcode (Required)

Which of the following applies to your situation? (Required)
—Please choose an option—SchoolCollegeEmployedApprenticeshipUniversityParent/CarerNot in education, training or employment

Do you know where to go for help and feel more confident asking for support when you need it?
—Please choose an option—YesNo

How would you rate each of the below? (0 = Strongly disagree, 10 = Strongly agree)
I feel emotionally well and able to cope with how I’m feeling most of the time.

I'm attending education, training, employment and its going well.

I feel physically healthy and take care of myself and body.

I have good relationships with people around me and feel confident when talking to others/family or friends.

I know how to manage my money well with no money concerns.

I don’t have concerns about drugs or alcohol affecting my life.

I feel safe and confident about my sexual health and relationships.

I feel safe in my community and when online.

I feel safe and secure where I live.

I don’t have concerns about getting into trouble with the law.

What's the main reason for your visit today?

Is there anything else you think we should know to help us support you? Please include any learning needs or disabilities.

Where did you hear about us?
—Please choose an option—School or collegeSocial mediaFriend or familyOnline searchLocal advertGPAnother agency or professionalOther