LFA Mental Health Support Registration Form

Dear ###form_user_auth_name###,

This form is for current London Film Academy students only.

The form will help us identify the best kind of support for you.

Please read the information below, and then complete as much of the form as you can.
Some fields/sections are mandatory *

Section 1/8 : Introduction

Registering for wellbeing support

Any information you provide will be treated sensitively. This information is read, in the first instance, by our Student Wellbeing Manager or by someone covering our wellbeing service. In the rare circumstances in which we are required to share information, we would always seek to discuss this with you first.

By submitting the form, you acknowledge you have read and understand our Confidentiality Policy and our Privacy Policy, which relate to the sensitive and confidential way in which we will treat the information you provide.

Our Student Support Team is normally open from Monday to Friday (9am-5pm). We are NOT a crisis service. Therefore, if you feel you are at immediate risk or if you need urgent help, you should visit Need Help Now page.

If you require help completing this registration form, email Student Support, or, alternatively, telephone 020 7386 7711 during our normal working hours.

Once you have submitted your form, we will contact you within 2 working days, with an offer of support.

Please tick the box below to confirm that you have read and understand the information above and would like to proceed to our registration form.

Yes, I understand the above information and would like to proceed to the registration form.*

This field is mandatory.

Section 2/8 : First of all, we need to confirm a few contact details

This information can be found in your MyLFA profile.

Your full name (first name and surname), as registered with London Film Academy: *

This field is mandatory.

The name you like to be known as (if different from above – otherwise, leave blank):

This field is mandatory.

Your LFA email address: *

This field is mandatory.

Your term-time address (including postcode): *

This field is mandatory.

Your preferred contact telephone number (only digits can be entered): *

This field is mandatory.

Can we leave a message on the above telephone number? *

Yes

No

This field is mandatory.

Section 3/8 : What would you like to discuss?

The answers to the following questions will help us to make the best choice of support. Please answer as fully as you feel able.

Please tell us what you would like to talk about: *

This field is mandatory.

How does this impact on your daily life? (Optional Question)

This field is mandatory.

How long have you been affected by these or similar issues? (Optional Question)

This field is mandatory.

Do you consider yourself at risk of failing your course?

Yes

No

Are you considering interrupting your course (for example, taking a year off)?

Yes

No

Are you considering leaving your course?

Yes

No

Before you move on to the next section of the form, we wanted to mention that, as an LFA student, you also have access to an online peer support community called Togetherall. Togetherall is an online space to connect, share and discuss what’s on your mind with peers.
To access Togetherall, visit the Togetherall website and select “Which describes you?” option: “I’m from a university or college”.

Section 4/8 : Health and wellbeing

Are you currently registered with a GP practice/doctor's surgery (in the UK)? *

Yes – I am already registered with a GP practice/doctor's surgery

No – I am not currently registered with any GP practice/doctor's surgery

This field is mandatory.

Are you currently taking any prescribed medication(s)? *

Yes

No

This field is mandatory.

Are you currently using substances (for example, alcohol or non-prescribed drugs) to self-medicate or to help you feel better about the way you are feeling? *

Yes

No

This field is mandatory.

What help or support are you currently receiving with any difficulties you are currently experiencing? This help or support may, for example, be from family, friends, or specialist support services.

This field is mandatory.

Section 5/8 : Disability support for students with long-term mental health conditions

If you have a diagnosed long-term mental health condition, you may be eligible for disability support. This support may enable you to access adjustments to help with your studies.

The Equality Act 2010 states that, to be classed as having a disability, your mental health issues need to have a ‘substantial’ and ‘long term’ negative effect on your ability to do normal daily activities. ‘Long-term’ in this context means that your condition must have lasted, or be likely to last, 12 months or more.

Thinking about the above definition, do you consider that you have a mental health issue which meets the definition of a ‘disability’ as set out in the Equality Act 2010? *

Yes

No

This field is mandatory.

Section 6/8 : Risk

Are you currently having thoughts about ending your life? *

Yes

No

This field is mandatory.

Do you feel at imminent risk of ending your life? *

Yes

No

This field is mandatory.

Do you have a plan to end your life? *

Yes

No

This field is mandatory.

Have you ever made attempts to end your life in the past? *

Yes

No

This field is mandatory.

Section 7/8 : If you are offered an appointment

Please tell us any days of the week when you are generally NOT available for an appointment:

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Do you have any individual requirements that you want or need us to take into account for any appointments? (Optional Question)

This field is mandatory.

Section 8/8 : And finally...

Is there anything else you think would be helpful for us to know? (Optional Question)

This field is mandatory.