Step 1 of 6 - Your Details

If you wish us to adjust the way that we communicate with you, please complete this Questionnaire. We are also able to send this form to you as a paper copy or it can be emailed as a ‘fillable’ PDF document. If you would prefer it in either of these alternative formats please contact us on law@robsols.co.uk or 029 20237777.

Name(Required)

First Last

Email(Required)

File Reference (if known)

Please indicate which department or which member of staff is dealing with your matter.(Required)

Do you have a visual impairment?(Required)

Yes

More information about your Visual Impairment

Do you wish us to communicate in large font?(Required)

Our standard font size is 11 but we would use size 16 font.

Yes

Is font size 16 sufficient? If not, please indicate a font size(Required)

Font Size 16

Other

Do you require larger font in both emails and letters?(Required)

Only Emails

Only Letters

Emails and Letters

If you require us to send letters on coloured paper, please indicate which colour.

Pink

Blue

Green

Yellow

Other

Please provide any other information you deem necessary.

Do you have a hearing or speech impairment?(Required)

Yes

More information on your hearing or speech impairment

Answering 'yes' to any of the questions below will allow us to ensure we communicate effectively when we speak to you.

Are you deaf or hard of hearing?(Required)

Yes

Do you have a speech impairment?(Required)

Yes

Do you wish for us to ONLY communicate with you via written correspondence (as opposed to telephone)?(Required)

Yes

If we communicate with you by telephone, do you wish for us to communicate via the Text Relay Assist Service?(Required)

We will happily accept calls from you through the Text Relay Assist Service (which can be contacted on 0870 240 9595 - calls are charged at 1p per minute plus your telephone provider's connection cost).

Yes

Please provide any other information you deem necessary.

Will you be accompanied to meetings with someone? Such as a support worker, signer or interpreter?(Required)

Generally, we are unable to provide a signer or an interpreter for meetings. However, we are content for meetings to be conducted with a support worker, signer or interpreter if you have access to the use of these professionals. We will just allow a little more time for the meeting to take place.

Yes

Do you have a mobility impairment?(Required)

Yes

More information on your mobility impariment

If you answer 'yes' to either of these questions, we shall arrange appropriate access to our office for your attendance.

Do you use a wheelchair or mobility scooter?(Required)

Yes

Do you have difficulty in climbing the stairs?(Required)

Yes

Please provide any other information you deem necessary.

Is there any other information you wish to provide in addition to the answers and comments above?(Required)

Yes

Please provide further information.(Required)

Consent(Required)

I have read and understood the Client Privacy Policy

Please confirm you consent to us holding and using this information (in accordance with the Data Protection Act 2008) for the purpose of making reasonable adjustments for us to communicate and hold meetings with you. Please note that all the information that you provide is retained securely and in line with our Privacy Policy. If you have any questions, please contact us.

Name

This field is for validation purposes and should be left unchanged.

Reasonable Adjustments