Advice Request Form

Use this form to set up an appointment with the RUSU Advice Service. A RUSU Adviser will get in touch after this form has been completed so please include all of your details below and then click the submit button at the bottom of this page.

How would you describe your ethnic origin?

White  British
 Irish
 Any other white background  
Mixed

 White / Black Caribbean
 White / Black African
 White / Asian
 Any other mixed background 

Asian or Asian 

British

 Indian
 Pakistani
 Bangladeshi
 Any other Asian background  
Black or Black British  Caribbean
 African
 Any other Black background   

Chinese or other

ethnic group

 Chinese
 Any other ethnic background   
 Prefer not to say                     

Middle Eastern

 Arabic
 Any other ethnic background   
 Prefer not to say                     

Do you consider yourself to have a disability?

i.e. any physical or mental impairment which has a substantial long-term effect on your ability to carry out normal day to day activities (tick)

 Yes       No       Prefer not to say

 

If yes, it would be helpful if you could specify your disability so we can make adjustments to your appointment.

Give brief details about your enquiry

We ask you to…

  • Treat Advisers, as well as other staff and visitors within the Advice and Representation Centre, in a courteous manner;
  • Tell us if you are unable to attend an appointment;
  • Keep us informed of any changes that may affect your case;
  • Tell us if it is unacceptable to telephone, email or send correspondence to your address (otherwise we will assume we can contact you using any contact details provided).

We will…

  • Explain your rights and responsibilities and help you decide what to do;
  • Put advice/information in writing (this may be via email) as appropriate;
  • Contact other parties on your behalf (with your permission);
  • Make every reasonable effort to contact you, but we will presume you no longer wish to use our service if you do not respond;
  • Keep a copy of your record for six years, after which time it will be securely destroyed, in line with our Data Storage and Destruction Policy;
  • Upon request, provide you with access to any data we hold on you electronically or on paper.  Further details are in our Data Protection Statement, which is available from your Adviser or the RUSU Data Protection Officer.

Advice Service terms and conditions

I agree that the Advice Service can keep a record of my case, and that my client information and case records may be accessed and audited by a person/organisation appointed by RUSU.

An Adviser will only act on my behalf or discuss my case with other parties with my permission, unless they have identified that I may be at risk of harm to myself or others, or for them to not do so would break the law.

I am happy for the Advice Service to contact me to request anonymous feedback.

NCP

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