Reasonable adjustments request

What is your disability?

For example, you may have difficulty walking, seeing, hearing or remembering things.

What reasonable adjustments can we make?

For example, you might need information in large print, extra time for appointments, or help to move around the clinic.

Consent to share

We would also like to ask for your consent to share information about your reasonable adjustments with other NHS and social care teams. This will help them understand what reasonable adjustments you may need when you see them.

Consent

Yes – I consent for my Reasonable Adjustment data to be uploaded to the NHS Spine (shared record)

No – I decline consent for my Reasonable Adjustment data to be uploaded to the NHS Spine (shared record)

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Reasonable adjustments request

Consent to share