Recovery and Empowerment Group Application

Recovery and Empowerment Group Application

Personal Information

We are sorry but it looks like you are out of area for RISE services, as we are only funded to support people who live in Brighton and Hove. We advise that you call the National Domestic Abuse Helpline for information about services in your area.

National Domestic Abuse Helpline:

0808 2000 247

Date of birth
Is it safe to call, text, or leave a voicemail on this number? *
Is it safe to email you at this address? *
Preferred Contact Method (Tick all that apply)

To help us to meet your needs, please tell us some more about yourself

Sex/Gender - tick all that apply
Language - are you okay communicating in English?
Do you need an interpreter?
Which languages - tick all that apply
Help you may need to use services
Sexual Orientation

Your ethnicity

Mixed / multi ethnic background
More about you

These questions help us understand your journey so far.

Have you ever reported the abuse to the police? *
Did you have a positive experience of the Criminal Justice System?
Has the abuse you've experienced led you to seek support for your mental health?

The following questions help us to understand how we can best support you to attend the course, and to measure how effective the course has been when you have finished. Please think about how you have been feeling over the past 2 weeks.

Regroup runs during the daytime (11am - 1pm) and evening (6 - 8pm)

Which group would prefer to attend?