Do you experience any challenges with your vision, hearing or speech that we should know about, so we can communicate effectively, respectfully and meaningfully with you? If so, please describe your communication preferences.
Future Footprints Conductive Education respects the rights of individuals and their families to privacy. To enable Future Footprints Conductive Education to provide your / your family with a quality service, we need to collect some personal information from you. To do this we require your consent.
When you first register with Future Footprints Conductive Education as a Consumer of our services we will request that you complete this Consent to Release / Request Information Form. A Future Footprints staff member will explain the form to you. You have a right to withdraw or limit consent at any time. However, this may make it very difficult for Future Footprints Conductive Education to provide the appropriate services to you / your family.
The information you provide us with, will also be used for:
Future Footprints will work closely with other agencies to coordinate the best support for you / your child. This means your informed consent for the sharing of information will be sought and respected in all situations unless:
Keeping children safe is an important role of all community service providers. If there are any concerns regarding a child’s safety, welfare or wellbeing, Future Footprints Conductive Education may be legally obligated to disclose information without parental consent under Chapter 16A of the Children and Young Persons (Care and Protection) Act 1998. In accordance with the principles of the Children and Young Persons (Care and Protection) Act 1998, wherever a child or young person is able to form his or her own views on a matter concerning his or her safety, welfare and well-being, he or she must be given an opportunity to express those views freely and those views are to be given due weight in accordance with the developmental capacity of the child or young person and the circumstances. Therefore, a child’s capacity to provide consent should be considered on an individual basis.
If you need any further information or have any questions or concerns about the collection and use of your personal information, please discuss with a Future Footprints staff member.
have read the above information and understand the reasons for the collection of my or my child’s personal information and the ways in which the information may be used and disclosed, and I agree to that use and disclosure.
I authorise for Future Footprints Conductive Education to:
I understand that my consent will continue until I advise Future Footprints Conductive Education in writing or verbally that I withdraw my consent.