Counselling and Health Request Support form

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1Introduction
2Privacy Notice
3Confidentiality Policy
4Your details
5Your health
6Your support
7Academic concerns
8Review and submit

Introduction

Please know that the Counselling and Health Advice Service is not an emergency support service. 

For immediate help, you can contact 1 of the following:

  • Samaritans - navigate high levels of distress with a confidential and non-judgemental listener
  • 111 - get medical help
  • 999 - call for emergency services.

Contact us

Complete this form if you are a student at University of the Arts London (UAL) and would like to contact the Counselling and Health Advice Service.

We aim to respond to your request within 2 working days.

If you would like to speak to someone sooner, we offer 20-minute Wellbeing Sessions daily Monday–Friday that are bookable 24 hours in advance. 

Find more information and book a 20 Minute Wellbeing Session.

Email StudentHealth@arts.ac.uk if you:

  • would like to talk to someone in detail about how we store your data and our Confidentiality and Information Sharing Policy (PDF 166KB) before completing this form
  • experience any technical difficulties completing this form
  • require this information in a different format.

Information about your rights in relation to the data that UAL collects and stores, and who to contact to exercise these rights, can be seen in the University’s Student Privacy Policy page.

Privacy Notice

This privacy notice relates to how the Counselling and Health Advice team collects and stores information so that we can provide you with appropriate support. Once you submit this form, a team member will contact you to offer help.

We will store the information you provide in this form and in future confidentially within the Counselling and Health Advice casework database. This is separate from your student record.

We will not share any information that you provide with anyone outside of the Counselling, Health Advice team without asking you for explicit permission first, unless the situation falls within the exceptions shown in the Confidentiality section.

We will retain records of your interactions with the Counselling and Health team for six years after you leave the University.

Legal basis

6(1)(a) consent of the data subject

9(2)(a) explicit consent of the data subject, for special category data (health, disability)

6(1)(b) Processing is necessary for the performance of a contract with the data subject or to take steps to enter into a contract, in all cases.
‘counselling’ under the ‘substantial public interest’ basis, under Schedule 1 of the General Data Protection Act 2018;
‘safeguarding under the ‘substantial public interest’ basis, under Schedule 1 of the General Data Protection Act 2018;
the ‘vital interests’ basis where there is an immediate threat to life
‘preventing or detecting unlawful acts’ under the ‘substantial public interest’ basis, under Schedule 1 of the General Data Protection Act 2018.
6(1)(c) Processing is necessary for compliance with a legal obligation, [JA2.1]

Storing your information

UAL Student Services’ casework system.

UAL systems for online forms, voicemail, email, and calendars.

Locked filing cabinet, if we need to keep original documents belonging to you, or we temporarily keep any notes or documents before transferring them to our database.

No storage or transfer outside the EEA.

Sharing information

Sharing within Student Services on a need-to-know basis as detailed in the Confidentiality and Information Sharing Policy (PDF 166KB).

No other sharing, unless you give explicit consent or the situation falls within the exceptions shown in the Confidentiality section below.

Retention

Data will be deleted in the 7th year after graduation.

Automated decisions

There will be no automated decision-making in the processing of this form.

All forms are reviewed by a person who will be replying or putting in place support for you.

The course and personal information you provide may be automatically updated. Our casework system checks the student record for any changes related to your course or personal details; for example, when you change your address, or when you progress from one academic year to another.

Do you agree to the Privacy Notice * REQUIRED

You chose not to allow us to store your information. We require this permission so that we can support you.

To continue, please agree with the Privacy Notice above.

You can return to this form at any time or email us at counselling@arts.ac.uk if you change your mind and require support from the Counselling, Health and Chaplaincy team.

Confidentiality Policy

The Counselling and Health Advice team is part of Student Services, and it operates to the Student Services Confidentiality and Information Sharing Policy (PDF 92KB). Please read it to find out more about our approach to storing and sharing information.

We usually ask students to give their explicit permission to share information, before we share it with others. We share information on a ‘need to know’ basis. This means we share the minimum information needed for another team, staff member, or organisation to support the student.

Student Services may occasionally need to share information without a student’s permission. This might happen in an emergency, or if the student or others are at risk of serious lasting harm. The Dean of Students, who oversees Student Services, decides when to share information without a student’s permission.

The Counselling and Health Advice team may use the information that you provide to send you information that may be useful to your circumstances, later in your studies. For example, if you tell us that you receive Student Finance, we may send an email to you to remind you to reapply for the following academic year. We only do this with your explicit consent.

Confidentiality Policy agreement * REQUIRED

We need to be allowed by you to store your information so that you can fill in this form.

If you change your mind or require support from the Counselling, Health and Chaplaincy team, you can come back to this form at any time or email us on counselling@arts.ac.uk.

Your details

Date of birth * REQUIRED
We usually correspond with students via their UAL email address. If you have any difficulties accessing your UAL email, please give us your preferred email address.
Are you currently in the UK? * REQUIRED
Where do you currently live while studying? * REQUIRED

Your health

Are you registered with a GP in the UK? * REQUIRED

If you have not registered with a GP in London, use Find a GP to locate your nearest practice. UAL students can also register with Holborn Medical Centre.

We strongly recommend you register with a GP in London.

Do you have an existing health condition that is relevant to your support request? * REQUIRED

Your support

Are you currently receiving support from any services or professionals? * REQUIRED
Tell us who you are currently receiving support from * REQUIRED
You can choose more than 1 option.
What kind of help are you looking for?
Please tell us your reason(s) for contacting us * REQUIRED
Please tick all the options that apply

Help is available

Please know that the Counselling and Health Advice Service is not an emergency support service. 

You can speak to someone today. Contact:

  • Samaritans - navigate high levels of distress with a confidential and non-judgemental listener
  • 111 - medical help
  • 999 - emergencies.

Counselling and Health Advice Service response times

The Counselling and Health team will contact you within 1 working day. If we can’t reach you, we may need to contact your Trusted Contact.

Read more information about out of hours and emergency support on our website.

Do you have any access needs that we should be aware of when working with you? * REQUIRED
For example:
  • step free access for in-person appointments
  • a Sign Language Interpreter.
Please let us know what you will need * REQUIRED
You can choose more than 1 option.

Academic concerns

Have you had difficulties with attendance this term/year? * REQUIRED
Are you contacting us to get evidence for extenuating circumstances (EC's)? * REQUIRED

You can self-certify for ECs for up to 60 credits per academic level or stage. 

You will have to provide evidence to apply for ECs if you have already self-certified for 60 credits. The Counselling and Health Advice Service can provide supporting evidence for Extenuating Circumstances if you have accessed support from the service before.

Find more information on how to make a claim for Extenuating Circumstances. 

Are you at risk of failing your course? * REQUIRED
Are you considering taking time out from your course or leaving university? * REQUIRED

Review and submit your answers

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