Brain in hand - personal technology for independant living

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To help us provide your support, please answer the following questions.
If you would prefer to register by phone, please contact us on 01392 247909 and we will be happy to help.

 

Fill in as much of the form as possible.  If there is information you do not know or would prefer not to answer you can leave the space blank.
If you have any questions, you can ask them at the end of this form.

 

Please press ‘submit’ today, even if you’ve not completed the form fully. You can update us by email us or give feedback at any time by clicking the links on your Brain in Hand landing page.

About You...

We need this information to confirm your funding, identify who your local Specialist Trainer is, and send out your Brain in Hand licence activation link.

Student's name:
Student's preferred name (if different):
Student's Date of Birth:
Student's Home Address:
Student's Term-Time Address:
Student's Contact Number(s):
Student's Email Address:

 


If you would like us to contact or copy in anyone else to support you when making arrangements for your Specialist Training (for example a family member), please provide their details below.

Supporter's Name:
Supporter's Relationship to you:
Supporter's Contact Number(s):
Supporter's Email Address:

By providing us with this information you agree we can discuss the details of your Brain in Hand service provision with the person named above.  Your supporter would be welcome to come to your Brain in Hand personal planning sessions too.





About Your University Support…

We will contact your University and your Non-Medical Help Provider to offer them information about Brain in Hand.

University Attending:

Campus (if more than one location)

My first academic year of DSA funding for Brain in Hand is:

My final academic year will be:

My mode of study is:
Disability Advisor (if known):
Which organisation provides / will provide your Specialist Mentoring service?

Specialist Mentor's Name:

Specialist Mentor's Contact number:
Specialist Mentor's Email:

What we do with this information


We routinely send Universities and HE providers updates about the student support we deliver – this includes when a licence was set up and how many hours of our support provision the students at that organisation has taken up.  It does not include any information about the contents of your Brain in Hand account.


Brain in Hand can be used within your university support sessions and your supporters may contact us to discuss your provision. We may talk to them about your Brain in Hand support package but will not share any information about the contents of your account.


If appropriate, we will invite your university supporter to your Brain in Hand Specialist Training sessions, so that they can support you as well as learn about Brain in Hand and use it collaboratively with you.


If you are happy for us to use and share your information in this way you do not need to do anything.  However, if you would prefer us not to discuss your service provision with supporters please let us know your consent to share preferences. You can access this link to update your consent to share preferences at any time by visiting our Student Support page (this link will be emailed to you after you register with us).





Your Brain in Hand Support Provision…


 


Your Brain in Hand Specialist Training


We will allocate you a Specialist Trainer to help you set up Brain in Hand and support you to develop your first strategies.


During your Specialist Training session you will need: 



  • Up to 2 hours to talk about what Brain in Hand can help you with and start to put strategies into your website

  • Somewhere quiet where you can use a laptop or pc with an internet connection.

Please tell us if you have preferences about where and when you would like your Specialist Training to take place:
Please let us know if you have any communication preferences or needs that we should be aware of when arranging or delivering the session:

What happens now?


1)   When we have received this registration form and a copy of your DSA2 letter, we will create your Brain in Hand account


2)   We will allocate you a Specialist Trainer to help you set up Brain in Hand and support you to develop your first strategies
Please note: we will share the contents of your registration form with your Specialist Trainer so that they can best support you to get started.


3)   Your Specialist Training may be provided at home before you go to university or on campus once you are there


4)   Your Specialist Trainer will contact you to arrange a suitable time for your first session


5)   We will encourage you to invite your Specialist Mentor or another supporter (such as a family member) to your Specialist Training


6)   Once your Specialist Training session has been arranged, you will receive a link to activate your Brain in Hand account so you can get started together.


Please tick here if you would like us to send you a link to activate your Brain in Hand independently prior to your training session (we must have also received your DSA2 letter and licence order in order to do this).

 




Your Needs Assessment


Your Needs Assessment Report (NAR) will help your Specialist Trainer to understand why you have been recommended Brain in Hand and how it might help you.

If you are happy to share this, please email us a copy of your Needs Assessment Report to DSA@braininhand.co.uk

Alternatively, please let us know where your DSA needs assessment was completed, so that we can contact them and request a copy directly:

By providing us with this information you agree we can discuss the details of your Brain in Hand service provision with the organisation named above.




 


Ensuring Quality


We are regularly audited to ensure the quality of our service and your data may be provided to the auditor for the specific purpose of carrying out the audit of our organisation - this includes a copy of documentation such as your timesheet, invoice to the funding body relating to the delivery of your NMH support (which will include your identity, type of NMH support, higher education institution and course information).  


To read more about the information we share in our audit process please click here. You can update your consent to share preferences at any time by visiting our Student Support page (this link will be emailed to you after you register with us).

Please let us know if you consent for your data to be used in our audit:




Your Brain in Hand Licence

The free Brain in Hand app can be downloaded from the Apple App Store onto iOS devices (version 8+) or the Google Play Store onto Android devices (version 4.0.3+).

For a step-by-step guide to downloading the app and information about compatibility please click here.

DSA will fund your Brain in Hand subscription for your time you are at university, for as long as you are using it and finding it beneficial.  If you are using Brain in Hand regularly we will renew your subscription for you automatically each year; if you are not using Brain in Hand we will contact you to ask your preference before renewing or cancelling your licence.




 


Your Brain in Hand Traffic Light Response Service


If you are a DSA funded student you can access remote support from a Brain in Hand Traffic Light Responder to help you make the best use of your technology for the first 120 days of Brain in Hand use (extendable within the first licence year where beneficial).


If you are not a DSA funded student please refer to your original quote or order information to see if you have purchased a Traffic Light Response Service for longer than the first 120 days (your Specialist Trainer will also confirm this with you during your session).

So that we can match you to the most suitable Traffic Light Response service, please select the option(s) below that best describes you.

If you would like to, please also add some notes about your specific needs.

Our support team will contact you when you reach 120 days to help you decide if you would like to extend your TLR service, send your notifications to someone else or turn them off.  


Your Traffic Light Responder and anyone else you nominate to receive notifications will have access to view and edit your Brain in Hand account content in order to best support you using Brain in Hand.


You can find out more about Traffic Light Responder options and change your TLR preferences at any time by visiting our University Edition Student Support page.  


Most students find the Traffic Light Response service beneficial, but if  you do not want to be connected to a Traffic Light Response service please let us know below.

 




 


Supporting you with Brain in Hand...


Please visit our University Edition Student Support page to find out more about Brain in Hand and Specialist Training, look at our support materials or read our policies.


Here you will find our Terms & Conditions, our cancellation policy and our complaints procedures.


The link to these resources will be emailed to you again when you activate your licence and can also be found by following the link at the bottom of your Brain in Hand profile page once your account is active.

 

Thank you for completing our registration form

A member of our team will be in touch soon to arrange your first Specialist Training session.

 

 

Name of person completing this form: Please provide an email address in the box below to receive a copy of your answers: