Initial Query: Student Wellbeing Form

Queen's University Belfast is committed to supporting all students throughout their time at Queen's. A wide range of support services are available to all students, which offer information, advice, and specialist services both internal and external to the University. We encourage students to engage with support services, to ask for assistance, and to consider their options and prevent, alleviate or resolve difficulties as they arise.

We know that confidentiality is important, and the University is committed to creating an environment where students are comfortable in seeking support.  A Student Support Agreement will be discussed at your first appointment, should you choose to engage in support from the service.  Student Wellbeing Service will hold and process your data in line with the University’s Student Privacy Notice

If you have a wellbeing issue or concern, please complete the form below and a member of the team will be in touch with you. If you are a member of staff concerned about the Wellbeing of a student, please contact us using our staff online form. 

SWS Form: Initial Query: Student Wellbeing Form

Section A: Student Details

Section B

It would help us to have some background information about your specific issue or concern, so if you decide to attend a meeting with us, we can collate relevant support information for your session. Please tick the box(s) below to provide us with some information relevant to your circumstances. (more than one can be ticked)

Emotional / personal
Academic
Physical health
Mental health
Relationship issues
Suicide ideation
Family
Finances
Hate Crime
Addiction
Traumatic event
Sexual Violence/Assault
Domestic Violence
Bullying / Harassment
Other (specify below)


Section C

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)

1 2 3 4 5 6 7 8 9 10

We take all requests for support very seriously and we endeavour to get back to students as soon as possible.

Student Wellbeing Service is available Monday to Friday, 9am -5pm and therefore the email account and forms are monitored during this period. The Service closes on recognised public holidays and University Closure Days.

The Following supports are available 24 hours, 365 days per year.

- Inspire Student Counselling: Freephone telephone service on 0808 800 0016 or email: qubstudents@inspirewellbeing.org
- Samaritans: 116 123 or Lifeline: 0808 808 8000
- 24 Hr Domestic & Sexual Violence Helpline: 0808 802 1414