Send us the details of your ME/CFS Service

Please read carefully and fill out the form below

Name of ME/CFS Service *

Address of Service *

Please include the full address, including Town/City and Post Code

Public Telephone Number *

Please provide a phone number where potential patients/clients can contact your service. If not available please write "none".

Public Email Address *

Please provide an email where potential patients/clients can contact your service. If not available please write "none".

Service Website *

Please provide the publicly accessible URL of your service. If not available please write "none".

Description of services provided *

Consider including: age range seen, severity seen, geographic boundaries, who you accept referrals from, do you provide diagnostic assessments, what therapy programmes you offer, what staff make up your team, remote access options (video/telephone/home visits)

Nominated Contact (for BACME internal use only) *

First

Last

We will only use this information for correspondence with you, it will NOT be posted publicly on our website.

Contact Email (for BACME internal use only)

Please tell us if you have a preferred email to use for contact from BACME (if different from above). We will NOT publish this on the website.

Data Protection *

• I consent to BACME storing my submitted information so they can respond to my inquiry and publicly display details of the ME/CFS service

Submit

Add an image

We have the facility to have a picture of your service on our website when your service details are accessed on the map so if you would like to use this feature please send us an image file to info@bacme.info with the name of your ME/CFS Service clearly marked.

Please ensure any image sent to us is of minimum resolution 1500px x 750px @ 72dpi and that you have obtained permission from anyone identifiably shown in the image.