Extended family member - Little Hearts Matter

Need to talk? Call us on 0121 455 8982 or chat with us on Facebook

Donate Become a member

Home
About us
Seeking support
Information
Family stories
Fundraising & volunteering
Shop
News & events
Contact
Youth Zone

Become a member

Become a member / Extended family member

Extended family member – Registration form

Becoming a member of Little Hearts Matter could not be easier and is free to anyone seeking support and information because they are affected by a diagnosis of a single ventricle heart condition.

Please fill in the form below and a member of our team will be in touch.

About you
Surname*
First name*
Address*
Address Line 1 Address Line 2 Town/City ZIP / Postal Code
Contact telephone numbers*
Email address*

If you do not have an email address, please specify NONE.
About the child
What is your relationship to the child?*
- Aunt
- Uncle
- Brother
- Sister
Child's name*
Child's date of birth*
DD slash MM slash YYYY
Child's diagnosis*
For LHM's information, are the parents of the child also members of LHM?
- Yes
- No
Any additional information
*
- I have read and agree to the LHM Membership Terms and Conditions*
MEMBERSHIP OF THE CHARITY REQUIRES AN OPEN AND HONEST SUBMISSION OF INFORMATION ON APPLICATION AND DURING THE TERM OF THE MEMBERSHIP
Contact
I would like to receive updates about the work of LHM, including support & information, fundraising and awareness campaigns. If so, please indicate below your preferred method of contact:
- Post
- Email
- Phone
Staying in touch
Your personal data is safe with us and we will never sell or share your details.
- White
- Mixed
- Asian or Asian British
- Black or Black British
- Chinese
- Any other ethnic background

Δ

Parent of a child with a single ventricle heart
Parent expecting a child with a single ventricle heart
Parent who has lost a child because of complex congenital heart disease
Grandparent, or expectant grandparent, of a child with a single ventricle heart
Adult with a single ventricle heart
Young person with a single ventricle heart, under the age of 18 years .
Extended family member
Health professional
Education professional
Social service professional
Friend of the charity

Make a donation

Be social with us - our latest tweets and posts

Fantastic to see two of our amazing members, Vinnie and Claire, raising vital #OrganDonation awareness on @ITV ❤️ @NHSOrganDonor @share_wishes itv.com/news/central/2…
Don’t forget to register for the benefits webinar this Saturday 22 Jan @10:30am. Pat will talk about welfare benefit entitlement, advice for disabled jobseekers, ESA, Universal Credit and PIPs.You'll need to be signed up to register: sfhearts.org.uk/members-area/#…

This message is only visible to admins.
Problem displaying Facebook posts. Backup cache in use.
Click to show error

Error: Error validating access token: Sessions for the user are not allowed because the user is not a confirmed user. Type: OAuthException

The LHM office will be closed from the 23rd to the 30th December, but our members can still contact us if they need a chat.📱 0121 455 8982📧 [email protected] ❤️Or drop us a private message ... See MoreSee Less

1 month ago ·

View on Facebook

· Share

Share on Facebook Share on Twitter Share on Linked In Share by Email

💬 Charlie is loving Christmas this year and is excited for Santa to visit!💬With Charlie’s Fontan operation likely to happen in the Spring next year we are enjoying every precious moment as a family this Christmas.❤ ... See MoreSee Less

1 month ago ·

View on Facebook

· Share

Share on Facebook Share on Twitter Share on Linked In Share by Email

Get in touch with Little Hearts Matter

Call our team on 0121 455 8982

Enquire online

Follow us

Sign up to our newsletter

Email*
Comments
This field is for validation purposes and should be left unchanged.

Δ

Sign up to our newsletter

A company limited by guarantee, registered in England and Wales, number 06442071

Registered Office: 75 Harborne Road, 4th Floor, Edgbaston, Birmingham, B15 3BU

Registered Charity No. 1123290

© Little Hearts Matter 2022

Terms and conditions of use
Privacy policy
LHM Cookie Policy

Website by thebluecube.com

Home
About us
Seeking support
Information
Family stories
Fundraising & volunteering
Shop
News & events
Contact
Youth zone