Yes / No If Please describe recognisable signs ‘Yes’ Epilepsy Epileptic seizure: Asthma Asthma attack: Diabetes Diabetic attack: Please supply any further medical information that the tutor needs to know to ensure your comfort and safety while attending courses at the college: General Information Physical (Mobility aid/level of support) Mobility Please tick Please tick Independent Ambulant Wheelchair Require supervision/assistance Ambulant Wheelchair Please tick Please provide further detail Orientation/Spatial Awareness Level of support: Able to orientate in unfamiliar surroundings information: Require general support Require 1:1 supervision Communication Type of aid: Normal speech/use an aid effectively Other information: Limited speech/inconsistent use of communication aid No speech /no communication aid Type of Aid: Sensory Impairment - hearing None Other information: Require some support to participate Require very specific support to participate Sensory Impairment - visual Type of Aid: None
Yes / No If ‘Yes’ Please describe recognisable signs Epilepsy Epileptic seizure: Asthma Asthma attack: Diabetes Diabetic attack: Please supply any further medical information that the tutor needs to know to ensure your comfort and safety while attending courses at the college: General Information Physical (Mobility aid/level of support) Mobility Please tick Please tick Independent Ambulant Wheelchair Require supervision/assistance Ambulant Wheelchair Please tick Please provide further detail Orientation/Spatial Awareness Level of support: information: Able to orientate in unfamiliar surroundings Require general support Require 1:1 supervision Communication Type of aid: Other information: Normal speech/use an aid effectively Limited speech/inconsistent use of communication aid No speech /no communication aid Sensory Impairment - hearing Type of Aid: Other information: None Require some support to participate Require very specific support to participate Sensory Impairment - visual Type of Aid: None