Required fields marked with a star

Name of student: Email address:

You have the right to confidentiality¹ in relation to your contact with the Progression Team. Information you share with us will not be shared without your consent. Should we need to contact others in relation to your support needs, we need your written permission to do so.

Consent to share

I agree that information concerning my support can be shared with those staff within University of Sunderland and external agencies identified below. This will enable the implementation of support in the identified areas:

Disability Support Team
International Student Support
Student Financial Advice
Academic (Lecturers, Tutors etc) & Administrative Staff within your School and Exams Team²
UoS Library Staff
Sunderland Futures
Funding Body
Chaplaincy
Student Wellbeing Service
Accommodation Services
Credit Control
Contact with 3rd parties, for example parent/guardian
Gateway staff
Student Finance England

If you would like to give consent for us to share information with someone (e.g. parent or guardian), please complete the information below:

Your full name Their full name Their relationship to you Their contact number Date, until which the consent to share is valid (or, specify if the date is indefinite):

Please note that you have the right to withdraw consent at any time. To do so please contact the Progression Team on 0191 515 2600 or at progression.team@sunderland.ac.uk. Withdrawing consent means that we will stop sending updates to whichever departments / external agencies you wish to remove from your approved list, from the date your consent is withdrawn.

¹ There are exceptional circumstances in which confidentiality can be broken:

• where there is a serious threat to the student’s personal safety
• where there is a serious threat to the safety of others
• where there is a legal requirement to disclose that information (e.g. where non disclosure would prejudice the prevention or detection of crime)
• in response to legal proceedings taken against the university

² In accordance with GDPR (General Data Protection Regulations), we cannot discuss any aspect of your support with anyone else without your permission. However, if you feel it may be helpful for another person to liaise with us on your behalf, you can give written permission to do so.