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. These standard include 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.

Accessible Information Standard Questionnaire
Please use format day/month/year e.g. 12/05/1979
What is your preferred method of communication? *
Do you require any of the following?
How would you prefer us to give you information?
How would you prefer us to contact you?
Do you prefer your written information in any of the following formats?
Do you currently use any of the following?

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.