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Book Your DSA Needs Assessment

To book your DSA Needs Assessment in any of our DSA centres please use the form below, or call 01926 464095.

  1. Please complete this form as fully as you can as this will help us assign the most appropriate assessor and suitable appointment to you. If you make a mistake you can change your entries as you go.
  2. When you have completed the form click the SUBMIT button at the end of the page to send your request to the AbilityNet DSA Team.
  3. We will contact you within five working days to confirm your details and agree a time and venue for your assessment.

We take your personal privacy very seriously and will not share your information with anyone else without your permission.

If you get stuck at any point please call us on 01926 464095 or email us on [email protected]

Required fields are marked by *

Please provide a telephone number that we can use to contact you in the next five days.
Please give us an email address so that we can forward relevant details when required. This could be your own address or your email address at University. Please choose the address which you check most often.
Please tell us the name of the University or college you are attending. If you are not yet attending University or college please tell us where you expect to be attending in the next academic year.
Please tell us the name of the course you are studying. If you are not yet attending University please tell us which course you expect to be studying in the next academic year.
Please could you select if your course is Full Time or Part Time
Please could you select whether your course is Undergraduate or Postgraduate
Please enter the year in which you commenced (or are hoping to commence) studying on your course at University.
Please enter the year in which you course is due to end
Please tell us about any disability you think is relevant to your needs. If you have a physical disability, visual impairment, or hearing impairment, please provide further symptoms, e.g. main symptoms, degree of impairment etc.
Do you have a DSA Entitlement Letter? If so please use this form to upload a copy as a pdf or scanned image. Don't worry if you don't have one or can't upload it as as you can provide it later.
Please enter your Customer Reference number
Please select where you would like your DSA Assessment to take place.
Is there a particular day of the week which you would like your assessment to take place if possible? Please tick all that apply.
Is there a good time for your appointment? Please tick all that apply
We can arrange to have a male or female assessor to suit your preference.
You may bring a chaperone with you if you wish.
Please state any additional requirements you may have for the Assessment e.g. BSL Interpreter, Blue Badge Parking, Accessibility,

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