Able2 Client Data & Privacy Consent

I understand my rights and responsibilities as outlined in My Service Agreement and I confirm that they have been explained to me. I understand my personal information is protected, and that no information about me will be released without my prior agreement. I have been given enough information to enable me to make an informed choice before granting my consent. I understand I have the right to withdraw my consent at any time. This consent may be varied by electronic communication means. Such communications, if they have been sent from your telephone number or social media or email address will be included in this consent.

Collection of Information

I give my consent for Able2 to collect my information as follows:

1. Personal information collected will depend on my relationship with Able2 and the service I have requested. It may include: a. my name, addresses, email address, phone number, date of birth, gender, identification details b. payment information in connection with a service or donation c. needs and circumstances (such as living or financial circumstances) d. information requested by Able2 from other health professionals and other community supports or service agencies involved in my care in order to implement my NDIS plan, strengthen my capacity or address barriers to participation. e. information requested by the NDIA. f. Internet Provider (IP) address or domain when using our website g. if you use social media to interact with Able2, any information that you allow the social media site to share with Able2 h. my working and/or donation history

2. Sensitive information will only be collected if it is specifically required for operational reasons. It may include my racial or ethnic origin, political opinions, religious or philosophical beliefs or affiliations, details of health, disability or criminal record; and/or my sexual orientation

3. I acknowledge there are some exceptions that do not require my consent. These include: a. Able2 must/needs to collect my information by law b. when the information is necessary for a legal claim c. my membership of a professional or trade association d. my membership of a trade union

Sharing of Information

In all cases information will only be shared with specific people or organisations that I have nominated, either in the attached appendix or provider list, or that is given by me to Able2 by electronic means as part of this consent. I give my consent for Able2 to:

1. Discuss my NDIS plan implementation with other health professionals currently involved in my care, including requesting information from health professionals about my care. 2. Release my personal information to other health professionals or service agencies to which I have agreed to be referred to in order to implement my NDIS plan. 3. Release de-identified information about the type and frequency of services provided to me for the purpose of data collection, analysis and reporting. 4. Release my information to other service agencies in the event of natural disaster or emergency where I may be directly impacted for the purpose of my safety. 5. Release my information to other agencies as needed for any audit and/or compliance checks.

Able2 Client Data & Privacy Consent

Media Release

Throughout the year there will be some memorable moments on our programs and groups. We would love to be able to capture these moments and share them with our community. We will only share your image/your young person’s image with your consent. I hereby give my unconditional permission to Able2 to use my photographic/filmed image for the purposes of promoting, publicising and advertising Able2. I understand the image(s) will remain the property of Able2 and may be used in its publications, website, and other publicity material and I expressly authorise such use. I give express permission for Able2 to crop or alter the image(s) as necessary. I waive any right to royalties or other compensation arising from or related to the use of the image. If you wish to allow us to use these photos or videos, please sign in the space below.

Schedule of Support Prices

1. I agree to accept one or more of the services listed below according to the goals & budgets set out in my NDIS Plan. 2. I accept the prices stated below or as per the current NDIS schedule of supports as published by the NDIS from time to time. 3. Where a participant joins an activity for a term the total for the whole term is payable irrespective of attendance after the first session.