Fill out the form below to become a member today. Membership is FREE.

A member is an adult with CMN or a parent of a child with CMN.

If you are not a parent of a child with CMN or have CMN yourself that you can register as a Friend of Caring Matters Now here.

As a member of Caring Matters Now you will:

  • receive a welcome pack with relevant support literature
  • receive a copy of our annual magazine
  • be introduced to a Support Contact
  • be invited to support and fundraising events

    Patient Details

    Patient Title *

    Patient Forename *

    Patient Surname *

    Patient Gender *

    Patient Date of Birth *

    Which race/ethnicity best describes you and your family? *

    Asian/Asian British - (Indian, Pakistani, Bangladeshi or Any other Asian background)Black, Black British, Caribbean or African - (Caribbean, Arican or Any other Black, Black British, or Caribbean background)Mixed or multiple ethnic groups - (White and Black Caribbean, White and Black African, White and Asian or Any other Mixed or multiple ethnic background)White - (English, Welsh, Scottish, Northern Irish or British, Irish, Gypsy or Irish Traveller, Roma or Any other White background)Other ethnic group - (Arab or Any other ethnic group)Rather not sayAnother race or ethnicity (please specify)None of the above

    Patient Nationality *

    Patients Native Language *

    Patient Contact Details

    House Name

    House Number *

    Address 1 *

    Address 2

    Town *

    County *

    Country *

    Postcode *

    Is the patient an adult? *

    Email Address *

    Landline Number *

    Mobile Number *

    Do you have any siblings? *

    Please enter details of your siblings

    Sibling {{rep-1_index}}

    Sibling Forename *

    Sibling Surname *

    Sibling Date of Birth *

    Next of Kin

    Parent / Carer Title *

    Parent / Carer Forename *

    Parent / Carer Surname *

    Parent / Carer Date of Birth *

    Relationship To Patient *

    Please state your relationship to the patient *

    Parent / Carer Email Address *

    Parent / Carer Landline Number *

    Parent / Carer Mobile Number *

    Would you like to add details of another Parent / Carer? *

    Parent / Carer 2 Title *

    Parent / Carer 2 Forename *

    Parent / Carer 2 Surname *

    Parent / Carer 2 Date of Birth *

    Relationship To Patient *

    Please state your relationship to the patient *

    Parent/ Carer 2 Email Address *

    Parent / Carer 2 Landline Number *

    Parent / Carer 2 Mobile Number *

    If you are likely to attend any of our events in the future, please make us aware of any additional information which would be relevant to planning events which are accessible for your family. For example: if anyone in your family has any accessibility or communication needs. Please detail below: *

    Details: *

    Other Details

    How did you hear about us? *

    CMN Details

    Please tick the area(s) of the body where the bulk of the CMN is located: *

    ScalpFacialRight ArmLeft ArmBoth ArmsRight HandLeft HandBoth HandsShoulderMain TrunkBackChestStomachRight LegLeft LegBoth LegsNumerous CMN (smaller CMN on various or all parts of the body)

    Any additional medical complications in relations to CMN? *

    If yes, please provide brief details:

    Has the CMN been treated? *

    Please state what treatments

    Medical Details

    Is the patient under the care of a local consultant? *

    Please state the name of the local consultant and hospital you are registered with *

    CMN Clinic and Research Details

    Are you registered with the CMN clinic at Great Ormond Street Hospital? *


    If you are not registered with the CMN clinic, would you like to receive further details? *


    Are you registered with the CMN research, which is taking place at Great Ormond Street Hospital? *


    Would you be willing to participate in the CMN research at Great Ormond Street Hospital, if you are not already? *


    Data Protection Policy

    Here at Caring Matters Now we take yours and your family's privacy seriously and will only use the personal information you provide on this registration form to create a personal profile, fulfil any requests from you and to help deliver and improve our services to you and your family.

    We promise to always keep the details you provide safe and we will NEVER share or sell the details you provide with unauthorised third parties. If anyone whose details have been provided to Caring Matters Now wishes to be removed from the communication list, please email  or call 07786 458883.  Please see our Data Protection Policy for more information. 

    To receive the best support and services we recommend you select all the contact options below. 

    Please contact me by (please tick): 
    Email – to receive charity invitations and developmentsPost – to receive a Welcome Pack upon registration and the free annual INSPIRE magazine (UK & Ireland only)Phone – to provide support and advice when requiredText – to receive reminders for events you have registered to attend (UK only)No contact

    By clicking ‘submit’ you consent to us contacting you and those you have detailed on the form about our services and ways you can help, including ways to volunteer, take part in research, donate to us and how you can get involved in our activities.