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Host Ukrainian Refugees Lincolnshire Network
HURLNET
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Counselling Request Form
Indicates required field
Full Name
Contact Number
Email Address
Preferred Contact Method
Phone
Email
Nearest Town/City
District
i.e. NKDC
Postcode
Christian Name of Patient
Age of Patient
Gender
GDPR
None of your information will be passed on to anyone other than the partners that we work with to enable the network to place refugee families with willing hosts.
Are you happy for us to share your information?
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Information message
Please bear in mind that this is an initial drive to establish a host network. Should circumstances change and the network is no longer required your data will be destroyed within 3 months of the closure of the network.
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