Advice Centre - Consent Form

Welcome to The Advice Centre. Please use this form to tell us a bit about yourself and what you'd like advice or help with and we’ll be in touch as soon as possible.

PLEASE READ THE GUIDANCE BELOW BEFORE FILLING OUT THIS FORM:

We'd really appreciate it if you could fill out all sections of the form before telling us about your query. This enables us to give you the most suitable advice for your situation and helps us understand who is using our services.

HOW WE USE YOUR PERSONAL DATA:

The Adviser that you see will make a record of your visit on our confidential case recording system.
As our service is confidential, only the Advisers can access your case record. Everything that you tell us will be kept confidential, unless we consider there is a risk to your own safety or others.

Please see our Confidentiality Policy for more information:
www.theunionmmu.org/advice-centre/policies-and-procedures

In this form we ask you to provide us with more information about yourself. We don’t have access to MMU student records so the more information that you give us, the easier it will be for the Adviser to give you the correct advice. However, you don’t need to give us any information that you don’t feel comfortable sharing.

We will keep your case records for six years after the last recorded piece of work has been carried out by an Adviser.

After you have used our service we will email you to ask you what you thought of our service.

Please ask for the Advice Centre privacy notice if you would like more information about our data protection policies.

Please answer the following questions:
Please answer the following questions:
I give consent for the Advice Centre to record personal information given on this form	I give consent for the Advice Centre to record personal information given on this form

Please complete the form below so that we can record your details on our confidential case recording system.
Name:
Date of birth:
MMU ID:
Pronouns (e.g. she/her, they/them)
Contact telephone number:
Preferred email address:
Course title:
Year of study:

(e.g. 1st year, 2nd year, 3rd year, Foundation)
Level of study:
Mode of study:
Fee status:
Please complete the table below if you are happy for us to gather data for statistical purposes. We use this information to check the groups of students our service is reaching. For example, we may run a report on the number of students with children who have visited the Advice Centre. Statistical information will be kept anonymous.
Gender:
Ethnic origin:
Do you have children?:

Do you have children?: Yes No Prefer not to say
Do you consider yourself to have a disability?:

Do you consider yourself to have a disability?: Yes No Prefer not to say
YOUR QUERY
Please tell us what your query is or what you would like advice with:
Thanks for completing the form. We only collect the information you tell us with for legitimate purposes and to fulfil your request and/or to deliver our services to you
(e.g. to process your enquiry).

For further information on how we manage and store your personal data, please visit: www.theunionmmu.org/privacy

Advice Centre - Consent Form

Advice Centre - Consent Form

Please complete the form below so that we can record your details on our confidential case recording system.

YOUR QUERY