Name: Clear Links Support
Address: Ecclesall Road, Sheffield, S11 8NX, GB
Telephone: 0114 278 6866

Personal Information

Contact Details

University and Course Details

Request for Support

Documents

Consent

Personal Information

First Name*

Last Name*

Preferred Name

Pronouns

Date of birth*

Contact Details

Address

Town/City

Postcode

Email address*

Phone number*

Preferred contact method
Mobile Text Email

University and Course Details

University/Campus*

Course title*

Course intensity*

Degree type*
Postgraduate Undergraduate PGCE PG Social Work

Approximate course start date*

Approximate course end date*

Request for Support

Availability*

Please indicate if you have a particular day or time when you would like the support to take place.

Name of your Needs Assessor

Please tell us the name of the Needs Assessor who conducted your DSA study needs assessment.

Funding Evidence

Upload Evidence *

Please attach the letter from your funding body which shows the type of support you have been approved and that Clear Links is the provider.

Do not attach medical evidence or needs assessments.

Maximum file size is 10MB

Consent

The General Data Protection Regulations (GDPR) require that we (Clear Links Support Ltd, The Portergate Building, Ecclesall Road, Sheffield, S11 8NX, 0114 278 6866, info@clear-links.co.uk) obtain your consent to process and share certain categories of your personal data.

Please note: you can change your consent choices, at any time, through Crystal.

Do you consent to Clear Links sharing your support plans, session records and reviews with your Higher Education Provider (HEP)? The data would be shared to allow your HEP to monitor the support we are providing to you.* I consent I do not consent

Do you consent to Clear Links sharing any wellbeing concerns we become aware of with your Higher Education Provider (HEP)? The data would be shared to allow your HEP to take any actions they felt appropriate. I consent I do not consent

Do you consent to Clear Links sharing information about your disability with your support worker(s)? This is classed as special category/sensitive data by the GDPR. This data would only be shared to allow the support worker(s) to deliver the appropriate support to you.* I consent I do not consent

Do you consent to Clear Links sharing the following data: your name, support role, HEP and course information with the Disabled Students’ Allowances Quality Assurance Group (the sector audit body). This data would only be shared to allow DSA-QAG to audit the support we provide to you.* I consent I do not consent

Please read our Privacy Notice which provides accessible information about our use of your personal data. It is important that you read this so that you are fully aware of how and why we are using your data and your rights over this data.

By clicking the submit button below, I confirm on 21 December 2024 that I am happy for Clear Links to process my data in line with my consent choices made above.