Disability Services



Pre-Registration Questionnaire

Introduction

Many thanks for taking the time to complete this short pre-registration questionnaire for Queen's University Disability Services.

Please note: Medical Evidence is required to register with the Service. For further guidance on Medical Evidence CLICK HERE.

At the end of this questionnaire you will be asked to upload your documents, so please be sure to have this information ready. If you have multiple files, please place these documents in a zip archive ready for upload.

Unfortunately appointments for registration will not be offered until we receive Medical Evidence. For further support and guidance please contact: disability.office@qub.ac.uk.

Disability and Wellbeing offer a range of specialist services to enable all students to have a positive learning experience. A specialist staff member can meet with you to listen to your issues, identify a range of possible options and ensure you have the right supports in place that meet your needs.

We know that confidentiality is important to you, and the University is committed to creating an environment where students are comfortable in seeking support. Disability and Wellbeing services will hold and process your data in line with the University's Data Protection Policy.

Please be assured that all information we receive is treated sensitively and that we only disclose appropriate levels of information to relevant University staff and associated personnel. However, it may be necessary for us to share information with relevant third parties including health and social care professionals, parent and/or next of kin if there is a known or suspected risk of harm to yourself or others. There may also be occasions where we have a legal obligation to share information and you will be advised of this. If you wish to view more details about how and when we will use your data, please refer to the Student Privacy Notice.

If you are residing outside of Northern Ireland (NI), please note the delivery of our services will be undertaken in accordance with the laws and regulation standards in NI, and any disputes will be subject to NI law.

Agreement to Student Support

Please sign below to indicate that you agree to participate with support from Disability and Wellbeing services, and the sharing of information on the above conditions.

Please note: You have the right to withdraw your consent to disclose information at any time. You can do this by informing us in writing to studentwellbeing@qub.ac.uk. Upon receipt of this request, a relevant staff member will make contact with you to discuss this further.


Please provide details of an Emergency Contact

This should be a trusted person over the age of 21, ideally living in the United Kingdom (UK). If you are living and studying outside NI, your emergency contact should be living in the same country that you are residing in.

Please be assured we will only contact this person if there are serious concerns about your wellbeing. However, it is recommended that you have a conversation with your nominated Emergency Contact to let them know that you have provided their details to the University.

 

Disability Type

Please select any relevant categories

Details of your disability or long term condition

Previous Educational Support arrangements

Please indicate any additional support you have received in relation to your condition

 

Please outline supports you may find useful for:

 

We may offer you an assessment via online video call or telephone

Medical Evidence Upload

Please upload your documents here.

If you have multiple files, please place these documents in a zip archive before uploading.

If you have a single file larger than 32MB you should zip it before upload otherwise it will exceed the file size limit.

Selected files: 0 Total size: 0