Get wellbeing support for yourself

Do you need help? If so, please complete and submit this form. Please include as much detail as possible to help us respond appropriately.

Click the submit button when you are finished. You will need to complete all sections and submit the form in one session. By completing this form you are consenting to being contacted through the email address you supply on this form.

Required fields are marked with an asterisk.

About you

About your concern

Impact on your studies

From 1 - not at all to 10 - coping very well
Are you thinking of leaving? *

About your wellbeing

Have you ever received treatment for a mental health issue? *

Consent Statement:

The information you supply on this form will help us respond to your request, including by phone. We'll treat your personal details with respect and keep them safe, and we'll never sell them to other third parties for commercial use. Please review our privacy statement for more information about how we use your data.