Consent Form

Please complete the form below

Step 1 of 2

Privacy Amendment Act

Personal information collection, holding, use and disclosure of personal information by this organisation is protected by the Privacy Amendment (Enhancing Privacy Protection) Act 2012 (Cth) (Privacy Act).

Personal information is any information or an opinion that identifies you or could identify you and includes information about your health.

The purpose for collecting personal information from you is to:

  • provide services, including planning, coordinating, funding, implementing, monitoring and reviewing our services
  • report to NDIS, government or other funding bodies of how funding is serviced by us,
  • take photographs and videos for therapeutic and marketing purposes
  • responding to your feedbacks, and
  • responding to your queries.
    * Please note that BDS is required to release information about service users (without identifying you by full name or address) to the Disability Services Commission and to the Australian Institute of Health and Welfare, to enable statistics about disability services and their participants to be compiled. The information will be kept confidential. This information is used for statistical purposes only and will not be used to affect your entitlements or your access to services. As a user of National Disability Agreement services you have the right to access your own files and to update or correct information included in the Disability Services National Minimum Data Set collection.

This organisation will not disclose/use information about you for any secondary purpose unless:

  • You have consented to the use or disclosure; or
  • You would reasonably expect us to use or disclose the information for the secondary purpose as it is directly related to the primary purpose; or
  • The use or disclosure of the information is required or authorised by or under an Australian law or a court/tribunal order; or
  • Our organisation reasonably believes the use or disclosure is necessary to lessen or prevent a serious threat to life, health or safety of an individual or to public health and safety; or
  • Our Organisation has reason to suspect an individual may have done something unlawful or engaged in serious misconduct that relates to organisational functions or activities;
  • Our organisation reasonably believes that the use or disclosure is reasonably necessary to assist another person to locate a person reported as missing.

I give authority to Beyond Disability Support to collect, store, use and disclose personal and sensitive information, including health records, for the primary purpose of service provision and directly related needs in accordance with the Privacy Amendment (Enhancing Privacy Protection) Act 2012 (Cth) whilst I/we remain a participant of this organisation.

If my circumstances change, I agree to notify Beyond Disability Support as soon as practicable.

Note: Where a participant does not have the capacity to give informed consent and does not have a legal guardian who has the authority to make decisions on behalf of the participant, the participant’s parent, family member or other person with a close personal relationship to the participant may sign this form. The person who signs on the participant’s behalf must print their relationship to the participant next to their name.