Consent Request Form

This form asks for your consent to allow us to use your personal data for the reasons stated below. You should only sign it if you want to give us your consent.

Who are we?

The name of the organization asking you for consent to use your information is:

Reed Wellbeing Limited

We would like to use the following information about you:

· Name

· Address

· Post code

· Email address

· Date of birth

· Telephone number

  • Gender
  • Ethnicity
  • Disability status
  • Information about your current lifestyle
  • Information about your wellbeing, including the following measures:
    • Nutrition
    • Alcohol
    • Smoking
    • Sleep
    • Exercise
    • Physical measurements, including height, weight, waist and hip circumference
    • Family medical history
    • Stress
    • Self-efficacy
    • Mental wellbeing
    • Social trust
    • Friends & family
    • Networks
    • Financial wellbeing
    • Your goals

Why would we like to use your information?

We would like to process the data requested above to perform a health assessment on you.

What will we do with your information?

Your information will be processed to provide you with an individualised Health Report. This will be available on the portal after your Wellbeing Check has been completed.

We will securely store this information for 8 years and may use anonymised data for the purposes of service improvement and research and development.

Please note that you would need to consent to Paypal’s terms of business and privacy notice in order to pay for the Wellbeing Check.

How to withdraw your consent

You can withdraw the consent you are giving on this form at any time. You can do this by emailing