Step 1
Step 2
Step 3
Secondary to Intensive Family Support Service Consent and Sharing of Information
SIFSSFT001
Do you require an interpreter?
No
Yes
Afrikaans
Albanian
Arabic
Armenian
Basque
Bengali
Bulgarian
Catalan
Cambodian
Chinese (Mandarin)
Croatian
Czech
Danish
Dutch
English
Estonian
Fiji
Finnish
French
Georgian
German
Greek
Gujarati
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Javanese
Korean
Latin
Latvian
Lithuanian
Macedonian
Malay
Malayalam
Maltese
Maori
Marathi
Mongolian
Nepali
Norwegian
Persian
Polish
Portuguese
Punjabi
Quechua
Romanian
Russian
Samoan
Slovak
Slovenian
Spanish
Swahili
Swedish
Tamil
Tatar
Telugu
Thai
Tibetan
Tonga
Turkish
Ukrainian
Urdu
Uzbek
Vietnamese
Welsh
Xhosa
Child/ren or young person/s details
Add Another Person
Your Consent
The Accoras IFS Program is funded by the Queensland Department of Child Safety, Youth and Women (DCSYW) and is required to collect and store personal information about our clients for recording and reporting purposes. DCSYW can only access general client data and uses this to produce information for policy development, funding administration and research and evaluation purposes.
Accoras privacy policy is published on our website and contains information about how, in accordance with the Right to Information 2009, you may access your stored personal information, seek correction of that information if required or complain about a breach of the Australian Privacy Principles, and how the organisation will deal with a complaint.
I consent to information about me and my child/ren being recorded as outlined above
I consent to be contacted for research and evaluation purposes
I understand that I can choose to withdraw my consent to this at any time.
Information Sharing
With your consent, Accoras IFS will share relevant and proportionate information with other professionals to discuss the support they have previously or are currently offering you. This helps us make sure you are getting the correct support, and there are no gaps or duplications. We will do this in line with the Information Privacy Act 2009.
Please be aware that in certain circumstances, we may be required by law to share information without permission. We will discuss these circumstances this with you during our first visit.
Service or Individuals you DO NOT want us to share information with?
I understand that I can add or remove services and individuals to/from this list at any time
I give Accoras IFS permission to share and discuss information with professionals and services currently involved with my family
I give permission for Accoras IFS to work with my child/ren individually
Signature (Draw)
Please sign before continuing
