Register Your Interest in ABC

Please indicate which programme you are interested in

ABC Anytime

ABC First Steps

ABC Main Programme

ABC Next Steps

Please indicate where you would like to access the sessions from

Access from home

Access from nursery

Access from school

Child/young person's Name*

First Last

Date of Birth

Parent/Carer Name(s)

First Last

Email*

Mobile number

Local Authority Area

Current Communication

Please give us details of your child/young person’s current communication

How does your child/young person mainly communicate? (Please only complete what is relevant to age/ stage. N/A is fine if your child is a very young baby – but tell us about early communication like eye gaze and pointing, etc.)

Do they have any other conditions that may impact their communication? If so, how does it impact them? Or are there certain things (sensory, environmental, time of day) that can impact their ability to communicate? Please give details.

Do they use single words, phrases or sentences? Please give examples.

Please describe any particular difficulties your child/young person has with speech.

Does your child/young person use Makaton or Signalong? Please give details of how they use it, ie: to augment verbal communication or as their main means of communication?

What Speech and Language Therapy input does your child/young person currently receive?

Is there any other information you would like us to be aware of regarding your child/ young person’s needs?

Where did you hear about our programme?

By submitting this form, you are consenting to Down’s Syndrome Scotland holding and processing your personal data, and that of your child, for the purposes of dealing efficiently with your enquiry and providing the best possible support. This information will be stored on a secure database and any paper records will be kept in locked filling cabinets. We will not share this with any third parties without your consent. We would also love to keep you updated on fundraising events and news and information relevant to our charity, including the services we provide. You can opt of receiving such information at any time. Your privacy is important to us, and we want you to know your details are safe with us. We will never give them away, sell them or swap them with anyone else. You can read our full privacy notice on our website at this link https://www.dsscotland.org.uk/privacy-policy/. You can withdraw your consent at any time by contacting our office at info@dsscotland.org.uk. You will also be given the opportunity to unsubscribe from our E-Bulletins every time we send them out. Please note that all processing of your personal data will cease once you have withdrawn consent, other than where this is required by law, but this will not affect any personal data that has already been processed prior to this point.

The use of photographs and video material of you/your child’s ABC session can be of great benefit to you/your child’s experience of the ABC service. Photographs taken will be used for ABC session materials and assessment purposes. Any video taken will be used for assessment and training purposes. In addition to the above, the use of photographs and videos in our marketing materials and publications, across all social media platforms, through our DSS accounts, funding applications and reporting, allows us to visually demonstrate our work. We only use images and video clips that we believe are positive and reflect the message we are aiming to portray. Any names we use will be first name only or can be anonymous if preferred. By giving permission to use images of you/your child/ your relative, you are giving consent to Down’s Syndrome Scotland to use images now and in the future. You may withdraw your permission at any time by notifying us via letter or email.

Please confirm are happy for Down’s Syndrome Scotland to use photos and video of me/my child/ family member according to the guidelines set above.*

I consent to the to use my photos/videos

I do not consent to the use of my photos/videos

I would prefer for my/child’s/family member’s names on photos and videos to be kept anonymous.*

Yes

ABC – Registration your Interest in ABC

Current Communication