Privacy Consent Form

As an NDIS participant in our service, Disability and Mental Health Care Pty Ltd, we need your consent to collect, store, and use your personal information to effectively deliver services. Please review this form carefully along with the Service Agreement, and sign it if you agree to the stated terms.

Protection of Your Sensitive Information

We respect your privacy and dignity. Thus, we only collect sensitive information like health, medical, and disability-related information when it's needed for service provision and only if:

• You provide explicit consent, or
• We're legally required to do so.

Your Consent

Before you give consent, our Workers will explain how we will use your data and who it may be disclosed to. They will ensure you understand everything clearly, providing assistance such as interpreter services or legal aid, as necessary. This consent can be amended at any time.

Informing You about Your Information

We will regularly inform you about how your information is used and stored. You have a right to access and correct your data, or lodge a complaint. Should you prefer, we encourage your involvement with family, friends, or chosen community in this process.

Information Collected

We may collect the following personal information: participant details, identifiers, service details, medical information, financial information, and interaction records. We may collect recorded material such as audio and visual formats.

How We Collect Information

We may gather your information from our website, your correspondence with us, forms filled in by you, face-to-face interactions, events, third-party referrals, or government agencies.

Purpose of Information Collection

We use this information to customise your support plans, answer inquiries, manage and improve our services, adhere to legal obligations, inform you about our activities, perform research, and improve your website experience.

Third-Party Disclosures

We may disclose your personal information without your consent in certain circumstances. This includes situations where there is an immediate risk of harm to you or others, or if required or authorised by law. Additionally we may share your personal information with organisations such as the NDIS Commission, funding providers, external auditors, regulatory bodies, law enforcement, courts, financial institutions, or external service providers, as necessary for service provision, legal compliance, or based on your authorisation.

Access to Your Personal Information and Complaints

The Disability and Mental Health Care Pty Ltd Privacy and Information Management Policy includes information about how you can access the personal information we hold about you, and how to make a complaint about a breach of your privacy or the Privacy Act, which will be dealt with in accordance with our Feedback and Complaints Policy.

Handling of Privacy Breaches

Any breach or alleged breach of your privacy will be taken seriously. Such incidents will be reported and managed as per our Incident Management Policy.

Contacting Us

For questions, concerns, or to request a copy of our Privacy and Information Management Policy, Feedback and Complaints Policy, or Incident Management Policy, please contact us on 0488 114 368.

Your Consent Preferences

You indicate your preferences by checking the corresponding boxes for each specific use of your personal information:

• Participation in NDIS audits and other quality assurance activities associated with maintaining Disability and Mental Health Care Pty Ltd's status as a registered NDIS provider.
• Participation in quality assurance activities including surveys, research, and complaint resolution.
• Inclusion in Disability and Mental Health Care Pty Ltd promotional activities and events.
• Receiving the Disability and Mental Health Care Pty Ltd newsletter. You may opt out at any time.
• Consent to the use of your personal information for the recruitment of employees, contractors, and volunteers.
• Involvement in the evaluation of Disability and Mental Health Care Pty Ltd's services and external reporting.
• Use of your data for internal training and operational processes.
• Receipt of marketing communications from Disability and Mental Health Care Pty Ltd. You may opt out at any time.
• Collection of information in audio and visual formats.
• Permission for photos to be published on Disability and Mental Health Care Pty Ltd's website or social media profiles.
• Information about me may be provided to other service providers.
• Information may be provided to appropriate authorities such as health professionals, pharmacy, medical specialists and so on.

Sharing my information

The form records the names and contact details of anyone you consent to have your (or the participant's) information disclosed to, and — irrespective of any request received — the names and contact details of anyone you direct us NOT to provide your (or the participant's) personal information to.

Future Withdrawal or Amendment of Consent

Please remember that your consent continues until you provide us with instructions to the contrary. You can withdraw or amend your consent to Disability and Mental Health Care Pty Ltd using your personal information at any time by providing written notice to Disability and Mental Health Care Pty Ltd.

Confirmation of Consent

By signing below, I confirm that I understand and agree to the use of my personal information as outlined above by Disability and Mental Health Care Pty Ltd. Signed and dated by the participant.

Consent by Representative (if applicable)

If you are providing consent on behalf of the participant: I, the undersigned, confirm that I am authorised to act on behalf of the named participant. I have read Disability and Mental Health Care Pty Ltd's Privacy and Information Management Policy and Incident Management Policy. I provide consent on behalf of the aforementioned Participant for the use of his or her personal information for the purposes set out and in accordance with the preferences set out above. I also consent to my personal information being used to administer this consent and to provide evidence of this consent to third parties as necessary. Signed and dated by the representative.

Declaration by Disability and Mental Health Care Pty Ltd Worker

I, as a worker of Disability and Mental Health Care Pty Ltd, solemnly affirm that I have provided a comprehensive explanation of the details outlined in this form to the Participant. This includes a thorough description of how their personal and sensitive information will be managed and protected by Disability and Mental Health Care Pty Ltd. Signed and dated by the worker.