Consent to Collect Personal Information
I give consent for Southern Cross Support Services to collect any personal or sensitive information that would be essential to make a clear and true assessment of my needs. This will allow SCSS to estimate the best support and service necessary to satisfy this referral.
In order to provide you the content requested, we need to store and process your personal data. Please check to confirm that you consent to us storing your personal data for this purpose.
As a 3rd Party representative of the Participant to this referral we require your confirmation and written authority from the Participant that we are able to collect the sensitive personal information of the Participant.
Please check the box above to confirm that you have received consent from the Participant for Southern Cross Support Services to collect any personal or sensitive information that would be essential to make a clear and true assessment of the Participants needs. This will allow SCSS to estimate the best support and service necessary to satisfy this referral.
Please understand that we cannot investigate this referal or progress this assessment until we receive valid consent that allows us to enquire into the participants relevant sensitive and personal details for the purpose of this assessment. This process will be on hold until the relevant consent is received.
I understand.