About this resource
This form lets the client choose who information goes to, what is shared, and for how long.
Purpose
A plain-language consent form for sharing client information between agencies.
Who it is for
Primary profession: Community services and case workers. Also relevant for social workers, youth workers, allied health and multidisciplinary teams.
Client or participant group: Case workers and community workers.
Practice setting: Community services.
Suggested uses
- Case coordination
- Referrals
- Family violence and housing support
Instructions for practitioners
- Add your details and delete what does not apply.
- Check it against your professional requirements.
- Explain it to the person in plain language.
- Store completed copies securely.
Accessibility considerations
Clear headings and tables. The Word version can be edited and filled in on screen.
Scope and limitations
A template for adaptation. It is not legal advice. Check it against your professional body's requirements, your insurer's advice and the law where you work.
Research basis
Health service providers must handle health information in line with the Privacy Act and Australian Privacy Principles, including telling people what is collected and why, and obtaining consent where required. Case management practice standards describe assessment, planning, coordination, review and planned exits with the person at the centre.
- Case Management Society of Australia and New Zealand. (2013). National standards of practice for case management (3rd ed.). https://www.cmsa.org.au/
- Office of the Australian Information Commissioner. Guide to health privacy. https://www.oaic.gov.au/privacy/privacy-guidance-for-organisations-and-government-agencies/health-service-providers/guide-to-health-privacy
What is included
A 2-page printable A4 PDF, including a practitioner notes page with the research basis (version 1.0).
Originality
Original Practitioner Plus content: wording, activity structure, layout and icons were created for this resource. No third-party worksheets, illustrations or text were reproduced. Written for Practitioner Plus from the sources in the research basis.
