Support Questionnaire - Trinity Laban

You are strongly advised to complete this questionnaire to ensure we provide you with the maximum amount of informed assistance
Even if the below criteria do not apply to you, it is vital you complete the questionnaire before starting your course.
The questionnaire is confidential and will not in any way affect your application.
Only specific Student Services staff will see the questionnaires. Responses will be stored electronically and deleted once you complete your course. Information will only be passed on to other parties with your consent.

‘Why is it important to complete this form?’

The more information we receive, the better we are able to cater to the specific needs of our students and we want to provide support and information where it is needed.

Information can also help us respond correctly to emergencies if and when they occur.

Your information can help us put in place arrangements so you are not unfairly disadvantaged.

The Conservatoire provides comprehensive support for students’ specific needs; we cannot be expected to provide support in situations where we remain unaware of your particular needs.

Thank you for your assistance and time.

First name*

Surname*

Email*

(please do not use your school email address as we will not be able to contact you once it has expired)

Mobile number*

Course*

Gender

Female
Male
Prefer not to say
Prefer to self describe

Prefer to self describe

Do you identify as Trans?

Yes
No
Prefer not to say

Would you like information about your pronoun preferences passed on to your direct teaching and support staff?

Yes
No

Disability

Please indicate which UCAS disability code applies to you:*

Please specify your condition(s) as selected above:

Would you like your specified condition(s) disclosed to your direct teaching & support staff?

Yes
No

Are you in receipt of, or have you applied for, Disabled Student Allowance?

Yes
No
N/A

Mental Health

Have you ever been diagnosed with a mental health difficulty? (e.g. depression etc)

Yes
No

If yes, what was the diagnosis

Is the condition still an issue for you?

Yes
No

Would you like your specified condition(s) disclosed to your direct teaching & support staff?

Yes
No

Would you like to be put in touch with the counselling service at Trinity Laban

Yes
No

If you require more information about counselling follow this link: http://trinitylaban.ac.uk/student-experience/student-support/counselling-support

If you have a severe mental health episode would you like us to inform a family member or friend?

Yes
No

If yes please complete the below information

Their name:

Their phone number:

Their email address:

Care Leavers

Are you leaving Local Authority care?

Yes
No

Estrangement

Are you estranged from your family? (i.e. have not had contact with either living parent/guardian for more than a year)

Yes
No

Digital Poverty

Do you, or will you have, reliable internet access during term time while on your course (excluding mobile data)?*

Yes
No

Do you have a camera enable device (other than a phone) you can access the internet on?*

Yes
No

Previous Criminal Convictions

Would you like to be made aware of the support we can offer those on probation or leaving prison?

Yes
No

Please be aware some elements of our courses are subject to DBS checks, please get in touch if you have questions about this. We can let you know what additional support you are entitled to if you wish to take advantage of this. This could include financial support, accommodation and other support services.