Skip to main content Skip to navigation

Staff Independent Assessment Tool

The following series of questions will highlight which actions are required to support your level of independence. If your mobility will only be affected for a short period of time (e.g. whilst recovering from a broken limb), or your medical condition is such, that you only experience periods where your mobility is temporarily affected, then this assessment is still relevant to you.

a. Are you able to hear a conventional fire alarm signal and evacuate the building, by moving horizontally and vertically through the building unassisted, to an external assembly point? (required)
b. Have you any form of hearing impairment? (required)
c. Can you hear the fire alarm in normal circumstances? (required)
d. Have you any form of visual impairment? (required)
e. Would your level of visual impairment mean you would have difficulty leaving a building unassisted? (required)
f. Have you any form of mobility impairment? (required)
g. Is there a medical reason why it would not be possible to transfer you from your wheelchair into an Evacuation Chair? (required)
Once you have submitted the information, it will be evaluated and a member of the ED&I Team will be in touch to either provide you with advice, or where deemed necessary, to arrange a Personal Emergency Evacuation Plan (PEEP).
Privacy notice

The University of Warwick will process your personal data, name, contact details, health information and needs, solely for the purpose of your safety while in University of Warwick buildings. This information will be shared with relevant persons if a PEEP is required, by completing this process you are consenting to this data sharing.

The legal basis for processing this personal data is because it is a legal obligation and also in order to protect the vital interests of the data subject or of another natural person.

Your personal data will not be shared or disclosed to any third parties external to the University of Warwick. Your personal data will not be transferred outside of the EEA, will be kept securely by the University of Warwick and will be retained in accordance with the period stipulated in the University of Warwick Records Retention Schedule.

The University of Warwick is the Data Controller of this information and is committed to protecting the rights of individuals in line with Data Protection Legislation. Please visit the University’s Data Protection webpages.  For further information in relation to your rights and how the University processes your personal data. The University’s Data Protection Officer can be contacted through or and any requests or complaints should be made in writing to the University’s Data Protection Officer.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at

Spam prevention

Failure to load reCAPTCHA

reCAPTCHA is a utility used to verify you're not a robot filling out this form. Unfortunately this has failed to load correctly.

Please try reloading the page. If the problem persists, or if you are in a country which blocks Google products, please contact us by using the ‘page contact’ link at the foot of this page.