Accessible Information Standard Questionnaire

The Accessible Information Standard tells organisations how they should make sure that disabled patients receive information in formats that they can understand and receive appropriate support to help them to communicate. All organisations that provide NHS or adult social care must follow the Accessible Information Standard by law. This standard includes making sure that people get information in different formats if they need it, such as: large print, braille, easy read, email etc.

Please complete this questionnaire to let us know if you require any communication or information support needs.

 
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Patient's Details

Information we need to register you with the practice
Please note all fields marked with a * are mandatory for your registration

 
  
 
  
 
 
  
What is your preferred method of communication?
Do you classify yourself as having one of the following?
Do you require any of the following?
How would you prefer us to contact you?
Do you currently use any of the following?
 

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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