Staff Contact us Form

Staff Contact Us form (Student Wellbeing Service)

If you are a member of staff concerned about the wellbeing of a student, please complete the form below and a member of the team will be in touch with you.

Section A: Staff Details

Please choose from the drop down below what School you are contacting us from or if your are based in a Service/Department please select 'non-faculty' and add what your Servic/Department name in the'other' box: If non-faculty please indicate what Service/Department below:

Section B: Student Details


It would help us to have some background information about the issue or concern you have about the student. Please tick the relevant box(s) below (more than one can be ticked)

Suicidal Ideation
Missing Student
Sexual Violence/Assault
Academic Progress Issue
Addiction Issue
Bereavement
Bullying/Harassment
Change in Behaviour
Domestic Violence
Family
Finances
Hate Crime
Mental Health (Stress/Anxiety)
Physical Health
Relationship Issues
Other (specify below)


Section C

What form of support do you feel would be beneficial to you?

Advice and guidance on what to do next
Signposting information on support organisations
Student appointment with a Wellbeing Adviser
Safeguarding advice

Staff at Student Wellbeing are committed to ensuring urgent cases are dealt with promptly. On a scale of 1 to 10 please rate how anxious, worried or concerned you feel by your specific issue or concern. (10 being very anxious, worried or concerned)

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