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Submitted URL: http://www.tinyurl.com/mpdzw27b
Effective URL: https://share.hsforms.com/17A-cBg6hRHughhAXHggMrA59qgq
Submission: On May 20 via manual from GB — Scanned from GB
Effective URL: https://share.hsforms.com/17A-cBg6hRHughhAXHggMrA59qgq
Submission: On May 20 via manual from GB — Scanned from GB
Form analysis 1 forms found in the DOM
<form id="hs-form-ec0f9c06-0ea1-447b-a086-10171e080cac-7982d408-8d4d-4ce6-995f-d2f40abdba1e" class="hs-form-ec0f9c06-0ea1-447b-a086-10171e080cac hs-form hs-form_theme-canvas" data-instance-id="7982d408-8d4d-4ce6-995f-d2f40abdba1e"
data-form-id="ec0f9c06-0ea1-447b-a086-10171e080cac" data-portal-id="8852282" lang="en" data-test-id="hs-form-ec0f9c06-0ea1-447b-a086-10171e080cac-7982d408-8d4d-4ce6-995f-d2f40abdba1e">
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<div data-hsfc-id="RichText" style="font-size: 14px; color: rgb(51, 71, 91);">
<h1><strong>Request form to add a service to Joy</strong></h1>
<p><br><strong>This form is for organistions wishing to promote their services on Joy<br></strong></p>
<ul>
<li>Once you have completed this form a member of our team will build a profile for you on Joy</li>
<li>Please note you will always be in total control of your services and able to edit/close/delete your services whenever you like<br><br></li>
</ul>
<p>For more information about Joy please check out the information pack here:</p>
<p>
<a href="https://explorejoy.co.uk/Welcome-to-Joy-84509402ab144614bfda06dc6b5a0727" rel="noopener" target="_blank"><img src="https://8852282.fs1.hubspotusercontent-na1.net/hubfs/8852282/image-png-2.png" width="422" height="240" style="width: 422px; height: auto; max-width: 422px;"></a><br><a href="https://explorejoy.co.uk/Welcome-to-Joy-84509402ab144614bfda06dc6b5a0727"></a>
</p>
<p><a href="https://explorejoy.co.uk/Welcome-to-Joy-84509402ab144614bfda06dc6b5a0727">https://explorejoy.co.uk/Welcome-to-Joy-84509402ab144614bfda06dc6b5a0727</a> <br><br><br><strong>Please complete the form below:</strong></p>
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<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-email hs-email"><label id="email-label" for="email-input" class="hs-form__field__label" data-required="true"><span lang="en">Your email address</span><span
class="hs-form__field__label__required">*</span></label><input id="email-input" class="hs-form__field__input" type="email" name="email" required="" autocomplete="email" inputmode="email" aria-invalid="false" aria-required="true"
value=""></div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-email_address_for_referrals_to_be_sent_to hs-email_address_for_referrals_to_be_sent_to"><label id="email_address_for_referrals_to_be_sent_to-label"
for="email_address_for_referrals_to_be_sent_to-input" class="hs-form__field__label" data-required="false"><span lang="en">Email address for referrals to be sent to</span></label>
<div id="email_address_for_referrals_to_be_sent_to-description" class="hs-form__field__description" lang="en">e.g. referrals@ageukwarwick.org.uk</div><input id="email_address_for_referrals_to_be_sent_to-input"
class="hs-form__field__input" type="text" name="email_address_for_referrals_to_be_sent_to" inputmode="text" aria-invalid="false" value="">
</div>
</div>
</div>
</div>
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<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-your_organisation_name hs-your_organisation_name"><label id="your_organisation_name-label" for="your_organisation_name-input" class="hs-form__field__label" data-required="true"><span
lang="en">Your organisation name</span><span class="hs-form__field__label__required">*</span></label>
<div id="your_organisation_name-description" class="hs-form__field__description" lang="en">e.g. Healthy You</div><input id="your_organisation_name-input" class="hs-form__field__input" type="text" name="your_organisation_name"
required="" inputmode="text" aria-invalid="false" aria-required="true" value="">
</div>
</div>
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</div>
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<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-subject hs-subject"><label id="TICKET.subject-label" for="TICKET.subject-input" class="hs-form__field__label" data-required="true"><span lang="en">Service name</span><span
class="hs-form__field__label__required">*</span></label>
<div id="TICKET.subject-description" class="hs-form__field__description" lang="en">e.g. weight management</div><input id="TICKET.subject-input" class="hs-form__field__input" type="text" name="TICKET.subject" required="" inputmode="text"
aria-invalid="false" aria-required="true" value="">
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-content hs-content"><label id="TICKET.content-label" for="TICKET.content-input" class="hs-form__field__label" data-required="true"><span lang="en">Service description</span><span
class="hs-form__field__label__required">*</span></label>
<div id="TICKET.content-description" class="hs-form__field__description" lang="en">Please share some information about your service</div><textarea id="TICKET.content-input" class="hs-form__field__input" name="TICKET.content" required=""
description="Please share some information about your service" aria-invalid="false" aria-required="true"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-specific_website_page_for_this_service__not_your_home_page_ hs-specific_website_page_for_this_service__not_your_home_page_"><label
id="specific_website_page_for_this_service__not_your_home_page_-label" for="specific_website_page_for_this_service__not_your_home_page_-input" class="hs-form__field__label" data-required="false"><span lang="en">Specific website page
for this service (Not your home page)</span></label>
<div id="specific_website_page_for_this_service__not_your_home_page_-description" class="hs-form__field__description" lang="en">Typically this is a specific page on your website that has information on this service - it is not your home
page.<br><br>We will research this page for updates to ensure that your information on Joy is accurate.</div><input id="specific_website_page_for_this_service__not_your_home_page_-input" class="hs-form__field__input" type="text"
name="specific_website_page_for_this_service__not_your_home_page_" inputmode="text" aria-invalid="false" value="">
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-eligibility_service_access_criteria hs-eligibility_service_access_criteria"><label id="eligibility_service_access_criteria-label" for="eligibility_service_access_criteria-input"
class="hs-form__field__label" data-required="true"><span lang="en">Eligibility/service access criteria</span><span class="hs-form__field__label__required">*</span></label>
<div id="eligibility_service_access_criteria-description" class="hs-form__field__description" lang="en">e.g. 18+ without complex mental health needs, based in the Northamptonshire area</div><textarea
id="eligibility_service_access_criteria-input" class="hs-form__field__input" name="eligibility_service_access_criteria" required="" description="e.g. 18+ without complex mental health needs, based in the Northamptonshire area"
aria-invalid="false" aria-required="true"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-location_of_service hs-location_of_service"><label id="location_of_service-label" for="location_of_service-input" class="hs-form__field__label" data-required="true"><span lang="en">Location of
service</span><span class="hs-form__field__label__required">*</span></label>
<div id="location_of_service-description" class="hs-form__field__description" lang="en">e.g. All of Cheshire, GU17 6HJ</div><input id="location_of_service-input" class="hs-form__field__input" type="text" name="location_of_service"
required="" inputmode="text" aria-invalid="false" aria-required="true" value="">
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-who_can_refer_to_your_service_ hs-who_can_refer_to_your_service_">
<div id="who_can_refer_to_your_service_-label" class="hs-form__field__label" data-required="true"><span lang="en">Who can refer to your service?</span><span class="hs-form__field__label__required">*</span></div>
<div id="who_can_refer_to_your_service_-description" class="hs-form__field__description" lang="en">Tick all that apply</div>
<div style="display: flex; flex-grow: 1; align-items: flex-start; justify-content: flex-start; flex-direction: row;">
<div class="hs-form__field__options__container" role="group" aria-invalid="false" aria-labelledby="who_can_refer_to_your_service_-label">
<div style="align-self: flex-start; flex: 0 1 auto;"><label id="who_can_refer_to_your_service_-label-1" class="hs-form__field__label hs-form__field__checkbox__label"><input id="who_can_refer_to_your_service_-input-1"
class="hs-form__field__input hs-form__field__checkbox__input" type="checkbox" name="who_can_refer_to_your_service_" aria-invalid="false" aria-required="true" aria-labelledby="who_can_refer_to_your_service_-label-1"
value="Anyone"><span class="hs-form__field__checkbox__label-text">Anyone</span></label></div>
<div style="align-self: flex-start; flex: 0 1 auto;"><label id="who_can_refer_to_your_service_-label-2" class="hs-form__field__label hs-form__field__checkbox__label"><input id="who_can_refer_to_your_service_-input-2"
class="hs-form__field__input hs-form__field__checkbox__input" type="checkbox" name="who_can_refer_to_your_service_" aria-invalid="false" aria-required="true" aria-labelledby="who_can_refer_to_your_service_-label-2"
value="Healthcare professionals"><span class="hs-form__field__checkbox__label-text">Healthcare professionals</span></label></div>
<div style="align-self: flex-start; flex: 0 1 auto;"><label id="who_can_refer_to_your_service_-label-3" class="hs-form__field__label hs-form__field__checkbox__label"><input id="who_can_refer_to_your_service_-input-3"
class="hs-form__field__input hs-form__field__checkbox__input" type="checkbox" name="who_can_refer_to_your_service_" aria-invalid="false" aria-required="true" aria-labelledby="who_can_refer_to_your_service_-label-3"
value="Self-referrals"><span class="hs-form__field__checkbox__label-text">Self-referrals</span></label></div>
<div style="align-self: flex-start; flex: 0 1 auto;"><label id="who_can_refer_to_your_service_-label-4" class="hs-form__field__label hs-form__field__checkbox__label"><input id="who_can_refer_to_your_service_-input-4"
class="hs-form__field__input hs-form__field__checkbox__input" type="checkbox" name="who_can_refer_to_your_service_" aria-invalid="false" aria-required="true" aria-labelledby="who_can_refer_to_your_service_-label-4"
value="No referrals"><span class="hs-form__field__checkbox__label-text">Signpost only/no referrals</span></label></div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-your_referral_form hs-your_referral_form"><label id="your_referral_form-label" for="your_referral_form-input" class="hs-form__field__label" data-required="false"><span lang="en">Your referral
form</span></label><input type="file" id="your_referral_form-input" class="hs-form__field__input" name="your_referral_form" multiple="" size="30" aria-invalid="false"></div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-please_upload_any_images_for_your_service hs-please_upload_any_images_for_your_service"><label id="please_upload_any_images_for_your_service-label"
for="please_upload_any_images_for_your_service-input" class="hs-form__field__label" data-required="false"><span lang="en">Please upload any images for your service</span></label><input type="file"
id="please_upload_any_images_for_your_service-input" class="hs-form__field__input" name="please_upload_any_images_for_your_service" multiple="" size="30" aria-invalid="false"></div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-anything_else_to_share_with_us_ hs-anything_else_to_share_with_us_"><label id="anything_else_to_share_with_us_-label" for="anything_else_to_share_with_us_-input" class="hs-form__field__label"
data-required="false"><span lang="en">Anything else to share with us?</span></label><textarea id="anything_else_to_share_with_us_-input" class="hs-form__field__input" name="anything_else_to_share_with_us_"
aria-invalid="false"></textarea></div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-we_will_accept_decline_referrals_within_30_days_of_them_being_sent hs-we_will_accept_decline_referrals_within_30_days_of_them_being_sent"><label
id="we_will_accept_decline_referrals_within_30_days_of_them_being_sent-label-1" class="hs-form__field__label hs-form__field__checkbox__label"><input id="we_will_accept_decline_referrals_within_30_days_of_them_being_sent-input-1"
class="hs-form__field__input hs-form__field__checkbox__input" type="checkbox" name="we_will_accept_decline_referrals_within_30_days_of_them_being_sent" aria-invalid="false" aria-required="true"
aria-labelledby="we_will_accept_decline_referrals_within_30_days_of_them_being_sent-label-1" value=""><span class="hs-form__field__checkbox__label-text">We will accept/decline referrals within 30-days of them being sent</span><span
class="hs-form__field__label__required">*</span></label></div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__group">
<div class="hs-form__field-row">
<div class="hs-form__field-row__column">
<div class="hs-form__field hs-form__field-we_will_attempt_to_contact_a_client_after_they_have_been_accepted_to_our_service hs-we_will_attempt_to_contact_a_client_after_they_have_been_accepted_to_our_service"><label
id="we_will_attempt_to_contact_a_client_after_they_have_been_accepted_to_our_service-label-1" class="hs-form__field__label hs-form__field__checkbox__label"><input
id="we_will_attempt_to_contact_a_client_after_they_have_been_accepted_to_our_service-input-1" class="hs-form__field__input hs-form__field__checkbox__input" type="checkbox"
name="we_will_attempt_to_contact_a_client_after_they_have_been_accepted_to_our_service" aria-invalid="false" aria-required="true"
aria-labelledby="we_will_attempt_to_contact_a_client_after_they_have_been_accepted_to_our_service-label-1" value=""><span class="hs-form__field__checkbox__label-text">We will attempt to contact a client after they have been accepted
to our service </span><span class="hs-form__field__label__required">*</span></label></div>
</div>
</div>
</div>
</div>
</div>
<div class="hs-form__row">
<div class="hs-form__actions"><button type="submit" name="Submit" class="hs-form__actions__submit" lang="en">Submit</button></div>
</div>
<div id="7982d408-8d4d-4ce6-995f-d2f40abdba1e-live-region-content" class="hs-form__visually-hidden" aria-live="polite"></div>
</form>Text Content
Skip to form REQUEST FORM TO ADD A SERVICE TO JOY This form is for organistions wishing to promote their services on Joy * Once you have completed this form a member of our team will build a profile for you on Joy * Please note you will always be in total control of your services and able to edit/close/delete your services whenever you like For more information about Joy please check out the information pack here: https://explorejoy.co.uk/Welcome-to-Joy-84509402ab144614bfda06dc6b5a0727 Please complete the form below: Your email address* Email address for referrals to be sent to e.g. referrals@ageukwarwick.org.uk Your organisation name* e.g. Healthy You Service name* e.g. weight management Service description* Please share some information about your service Specific website page for this service (Not your home page) Typically this is a specific page on your website that has information on this service - it is not your home page. We will research this page for updates to ensure that your information on Joy is accurate. Eligibility/service access criteria* e.g. 18+ without complex mental health needs, based in the Northamptonshire area Location of service* e.g. All of Cheshire, GU17 6HJ Who can refer to your service?* Tick all that apply Anyone Healthcare professionals Self-referrals Signpost only/no referrals Your referral form Please upload any images for your service Anything else to share with us? We will accept/decline referrals within 30-days of them being sent* We will attempt to contact a client after they have been accepted to our service * Submit