Consent to Share enables a participant to give signed consent for ConneXtions - Plan Managed Option employees to discuss personal and plan information over the phone or via email with additional parties such as Secondary Contacts (your parent, a co-parent / guardians, grandparents, close friends etc), Support Coordinators or others.
Only you (Participant ), your Guardian or Authorised Representative may give consent to share. The information we share can include your current budget amounts, information about recent invoices and providers you have engaged, client details and representative contact details. You can tell us what you want to share.
Giving additional parties consent to access your personal information is purely optional and will not affect our services. You have the ability to add or remove people to your Consent to Share list in the future.
(the client or the name of the guardian or authorised representative to act on behalf of the client), hereby consent to ConneXtions - Plan Managed Options sharing information about my/the NDIS plan with the following parties:
Secondary Contact (eg: your parent, a co-parent / guardians, grandparents, close friends etc)
Please tick relevant information to share:
Client Name & NDIS Number PlanClient/Representative contact detailsBalances, spending & dateConfirmation of services providedOther Services I access
I declare that I have the authority to approve this consent to share form in the following capacity as:
The ParticipantA parent of the Client who is under 18 y/oA Guardian/Authorised Representative of the Client
You may change these permissions at any time by sending written notification to email@example.com
Your Name (required)
Your Email (required)