enhancing life for
people with dementia
in East and West Wiltshire

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First Name * : Surname * : Email * : Telephone : Name of organisation :

Address Line 1 : Address Line 2 : Address Line 3 : Town : County : Postcode :

Are you :

Worried about your own memory (self-referring) A family member A professional

I would like to find out more about :

Support at Home Day clubs Carer's groups Training for Carers Alzheimer café Singing for the Brain General information about our services General information about dementia For security, please enter the number into the box [9] * :

Working Together:

Alzheimer's Society / Leading the fight against dementia

Carers in Wiltshire

Avon and Wiltshire / Mental Health Partnership NHS Trust

Wiltshire Council / Where everybody matters

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