Complete the form below to request support from our Telephone Peer Support Service. A member of our team will contact you about matching you with one of our trained volunteers. First Name Last Name Email Phone number? What's your age? What's your connection to cardiomyopathy? FS1 - Select -I have cardiomyopathy or a related conditionI am a friend/family member of someone with cardiomyopathyOther If you'd like to tell us more, please do so here Do you have a device fitted and if yes, what type? We want to make sure that the peer support relationship is as meaningful as possible and will take into consideration any preferences or accessibility needs you may have. Please let us know here Are there any preferred days and/or times for a volunteer to reach you? If there's something specific you'd like to talk to a telephone support volunteer about, please let us know here What are you hoping to achieve from speaking to a telephone support volunteer? Would you like to receive email updates from us about the latest support and information for people affected by cardiomyopathy, our campaigns, research and ways to get involved? Yes No