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About you

How we use your information

By submitting this form, you are consenting to this information being shared with staff who can provide you with support. However, depending on what you have written, we may also need to share information with others. At registration, students can choose to ‘opt-in’ to a policy that allows us to contact your nominated emergency contact if we have a significant concern about your welfare. This is explained in the  Student Emergency Contact Procedure. We will always try to discuss this with you first. In an emergency we can contact your nominated emergency contact regardless of whether you have 'opted in' to this policy. For example, if we believe you are at risk of harming yourself or others, we are obliged under our duty of care to override confidentiality. Depending on the urgency of your situation, we may not be able to discuss this with you first. Further information including a list of University services that operate in this way can be found in the Education and Student Experience Division Confidentiality Statement. By submitting this form, you are consenting to this information being shared with staff who can provide the student with support. However, depending on what you have written, we may also need to share information with others. At registration, students can choose to ‘opt-in’ to a policy that allows us to contact their nominated emergency contact if we have a significant concern about their welfare. This is explained in the  Student Emergency Contact Procedure. We will always try to discuss this with the student first. In an emergency we can contact their nominated emergency contact regardless of whether they have 'opted in' to this policy. For example, if we believe they are at risk of harming themselves or others, we are obliged under our duty of care to override confidentiality. Depending on the urgency of the situation, we may not be able to discuss this with the student first. Further information including a list of University services that operate in this way can be found in the Education and Student Experience Division Confidentiality Statement.

Request Wellbeing Support

Thank you for completing this form. We have received it and will review your request for support before the end of the next working day.

We aim to respond to all requests for support as soon as possible, but during periods of high demand there may be a delay and we thank you in advance for your understanding and patience.

However, if your situation changes and you want to tell us about this, please call Wellbeing Access on +44 (0)117 456 9860 or email wellbeing-access@bristol.ac.uk so they can update the information on your form. We will contact you again as soon as possible.
Thank you for completing this form. We have received it and will review your request for support before the end of the next working day.

We aim to respond to all requests for support as soon as possible, but during periods of high demand there may be a delay and we thank you in advance for your understanding and patience.

However, if your situation changes and you want to tell us about this, please call Wellbeing Access on +44 (0)117 456 9860 or email wellbeing-access@bristol.ac.uk so they can update the information on your form. We will contact you again as soon as possible.
Complete this form to request wellbeing support for yourself or a student at the University.

If you need help completing the form, please call Wellbeing Access on +44(0)117 456 9860 or email wellbeing-access@bristol.ac.uk.

For urgent and emergency care

Do not use this form. Call 999 immediately or go to your nearest hospital. After calling 999, if you are on Campus call Security Services on 0117 3311223.

Who are you requesting wellbeing support for?


 
 
 
  
 
 
 
Your student number is a 7 digit number that you can find on the back/front of your University ID (UCard). For example, 1234567. If you do not know what your student number is you can find it by logging in to Student Info.

Help us to help you get the right support

 
 
 
 
 


For each of the following, please say when this happened most recently - if ever:































 
 
 
 
 
 

About the student requiring support

 
 
 
 
Please provide as many of these details as you can (this means we can be sure we have the right person)
 
 
  
 
 
 
 
University of Bristol,
Beacon House,
Queens Road,
Bristol, BS8 1QU, UK.
Tel: +44 (0)117 928 9000

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