Please read the Community Adult Asperger Service confidentiality agreement. 

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Do you understand why we have asked you for your mobile/telephone number and email address? Required
Are you are happy for us to communicate with you using these methods? Required

Communication consent

We use your contact details to send confirmations and reminders for appointments, test results, requests for contacting the service and for post treatment feedback surveys to improve patient experience.

Do you consent to Dorset Healthcare using your contact details for the above reasons? Required
Do you give consent for communication by telephone? Required
Do you give consent for communication by SMS message? Required
Do you give consent for communication by email? Required
Is there a parent/carer who should receive a copy of correspondence? Required

Communication support needs

Do you have a communication support need? Required
Please state your preferred language Required
Most of our clients are contacted by email. Do we need to contact you in a different way? Required
Do you need information presented in a different format? E.g. easy-read, Braille, audio. Required
Do you need an interpreter? Required
Do you use a communication aid? Required
Please tick each box to confirm you have read the following information. Required
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Privacy policy Required