Keeping Neurodivergent People Connected in Leeds (Advonet) - Form

0%
 

This is a survey about the Keeping Neurodivergent People Connected project, asking what you would like from it. Advonet are one of the services that are funded to run short term information support for people in Leeds with neurodivergent conditions. These include autism, ADHD, dyslexia, dyspraxia, dyscalculia and Tourette’s Syndrome, as well as people with learning disabilities.

The Keeping Neurodivergent People Connected service will provide information by phone, email and text on staying safe during the COVID-19 crisis. This survey asks you a few questions about what support we can offer you through this project.

1. Your name *

 

2. Your address *

 

3. Your phone number *

 

4. Your email address *

 

5. Do you consent to Advonet using your data to contact you? *

 

6. Emergency contact details - please write down the details of someone to contact in an emergency. They could be a parent, partner, grandparent, close friend, social worker or other relative.