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Form

Single Advice Session - Agreement for Study Abroad and Distance Learners

Thank you for requesting a Wellbeing Service Single Advice Session.

The emphasis on this session will be to:

  • Identify current issues that you are experiencing
  • Offer support, advice and guidance
  • Formulate a plan of next steps
  • Explore support, resources & networks available to you

When supporting students at a distance it is essential that safe working guidelines are followed for both student and practitioner. Therefore, we request that you complete, sign and return this form before a session can take place.

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Please complete details for AT LEAST two of the following people: - Next of kin/significant other - Staff member in study abroad institution or work placement - Medical/GP contact in study abroad area or distance learner's home area
Contact 1
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Contact 2
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Other (optional)
Other (optional)
I understand Wellbeing Services are unable to offer a crisis or urgent response service to students abroad or at distance. I recognise that support offered during and after the session will be limited by nature of being remote.
If there are significant concerns about my safety, I understand the practitioner may contact the people listed here and/or other relevant professional or university services. I understand any information would be shared on a need to know basis.
I will complete, sign and return this agreement to Wellbeing Services.
I understand Wellbeing Services will aim to offer me an appointment within 2 weeks of returning this form. However I acknowledge that this period may be longer during times of high service demand and University vacations.
Where it is agreed that a session will be conducted by email further guidance on this process will be sent to me.
Where it is agreed that this session will be conducted by telephone I understand it is my responsibility to check with my service provider about any additional charges for receiving/making international calls.
I am aware that no online service can be 100% secure in terms of privacy & security.