Form 18. Participant Information Consent Form

Participant consent for use and disclosure of personal information

We collect information about you for the primary purpose of providing quality support and services to you.

We need to collect some personal information from you to ensure our services meet your needs. If you do not provide this information, we may be unable to fully provide these services. This information will also be used for:

Administrative purposes for running our service

• Billing you directly, through the NDIS, or another agency if required

• Use within our service to ensure you are provided with quality support and services

• Disclosure of information to the NDIA, the NDIS Quality and Safeguards Commission, or other government agencies if needed

• Disclosure of information to health professionals to ensure high-quality health care for you if needed

• Disclosure to other providers, with your consent, to provide appropriate services.

• Nutrition information and mealtime management

Attainable Care is required to disclose some or all this information to NDIS and/or to another organisation.  Attainable Care may also disclose your personal information to another service provider if you commence working with another service provider. Disclosure to other government departments, government authorities and researchers may also occur for the purpose of ensuring that you are provided with good quality services and assistance. If you are an NDIS participant, your personal information may be used to give you the services and/or payments that you need.

• Have read the above information and understand the reasons for the collection of my personal information and the ways in which the information may be used and disclosed and I agree to that use and disclosure.

• Understand that this consent is valid only for the time specified.

• Understand that it is my choice as to what information I provide, and that withholding or falsifying information might act against the best interests of the supports and services I receive.

• I am aware that I can access my personal information and shift notes on request and if necessary, correct any information I believe to be inaccurate.

• Understand that if, in exceptional circumstances, access is denied for legitimate purposes, the reasons for this and possible remedies will be made available to me

• Have been provided with or have been given an opportunity to obtain a copy of Privacy and Confidentiality P&P via the client handbook.

• My support workers have discussed with me and I understand that Attainable Care may take video/voice recordings during the service provision.

I hereby give consent to release my personal information to Attainable Care either verbal and/or written and/or recorded material in audio and/or visual format, to/from:

Should you wish for your information to be amended or withdrawn, ensure you contact Attainable Care in writing to indicate these changes or withdrawals.

Audit:

As a registered NDIS Provider, there is an obligation to undergo regular audits to ensure compliance with the legislation requirements. The audit process involves auditing contacting some clients to discuss the services received and the client’s level of satisfaction.

Your participation in this is not compulsory.

Media:

Profile photos may be taken to assist in the delivery of services. These photos will not be published outside of the management system. The usage of these photos will company with the Australian Privacy Principles and abide by Attainable Care’s Privacy and Confidentiality Policy. 

Vehicle:

I give consent for my own private vehicle for transportation arrangements with Attainable Care staff to drive it and will provide the below information to Attainable Care

• Vehicle registration papers, that include:

• Vehicle registration number

• Vehicle registration expiry date

• Type of vehicle

• Third-party insurance

• Comprehensive insurance

Verbal Participant Consent:

OR

Written Participant’s Consent

OR

Personal information collection statement

You may contact us by email, mail or phone using the details provided at the bottom of this page. You have the right to gain access to the information we hold about you. Our privacy policy (available upon request) contains information on how you may request access to, and correction of, your personal information, how you may complain about a breach of your privacy and how we will deal with such a complaint.

We need to collect information about you for the primary purpose of providing quality support and services.

To fully provide these services, we need to collect some personal information from you. This

information will also be used for the administrative purposes of running the practice such as billing you or through the NDIS. Information will be used within the service for planning and managing your plans and

supports.

We may disclose information regarding you to other service providers or health professionals only with your consent. We will not disclose your information to commercial companies, however, specific service or product information as deemed suitable for your management may be forwarded to you by us, unless you instruct us not to forward this type of information. Your written consent will be obtained at the start of any new planned activities. We do not disclose your personal information to overseas recipients.

File information is stored securely and accessed only by our workers. We take all reasonable steps to ensure that information collected about you is accurate, complete, and up to date. You may have access to your

information on request and if you believe that any of the information is inaccurate, we may amend it

accordingly. If you do not provide relevant personal information, in part or in full, this may result in the

provision of incomplete support or services which may impact your plans and goals. Any concerns you may have about this statement or the information we store about you can be directed to our Director.