Student Support Team - Medical Questionnaire

Student Support Team – Medical Disclosures

Name*
First Last
Date of birth*
DD slash MM slash YYYY
Cohort*
GP surgery name*
GP telephone number*
Medical conditions*
Medications taken*
Allergies*
We use the information you provide for the purpose of support. The Student Services team collate information provided by individuals, which will then be shared with other members of staff within education (where appropriate) such as Additional Learning support and tutors. As a result of the disclosures made in this questionnaire, you may be contacted with an offer of support. Full details are available in our privacy policy.

If you need any medication stored on site, please refer to Confetti’s medication policy and contact Additional Learning Support or Student Services.