Social Prescribing

If you are interested in offering cycling to your patients as part of a social prescribing program get in touch and we will send you details on funding and how it operates. Social Prescribing inquiry.

If you are a health/care officer or GP and have agreed the funding for social prescribing please complete the form below and we will arrange for a bike and accessories to be delivered to your patient.

Patient Details
Full name
DOB
Email address
Phone number
Address line one
City
Postcode
Height
Gender
Age range
Ethnicity
Employment status
What is your current cycling ability?
Select a barrier you have previously faced with cycling
Would you prefer step through or crossbar? *
What is your main reason for getting a bike?
Do you intend to use your bike as a mode of transport to replace
Please tell us where you will storing the bike at night
Any other comments
Health / Care officer / GP details
Contact name
Name of organisation
Contact email
Contact phone
Contact address line one
Contact city
Contact postcode
Delivery Details
Full name
Email address
Phone number
Address line one
City
Postcode
We deliver Mon-Fri - are there any days you cannot take delivery?

Social Prescribing

Patient Details

Health / Care officer / GP details

Delivery Details