Information Consent Form

To ensure quality of service provision and, in some instances, obtain government funding, PoDDSS may need to share relevant information about you / your child with other agencies. For further information about the confidentiality of your personal information please refer to the PoDDSS Privacy Policy.

CONSENT TO VIDEO, PHOTOGRAPHY AND MEDIA

I/We hereby give permission for photographs/video footage of the above named to be used by PoDDSS for the following purposes

I/We UNDERSTAND THAT:

• any photographs, video footage and other images taken by PoDDSS may be shown in a public environment. • Photos or videos will not be given or sold to third parties. • PoDDSS may keep and use photographs and video footage unless otherwise notified in writing. • There is no payment for appearances in any photo or film used by PoDDSS. • PoDDSS staff will always have the client and their family’s best interest in mind when using the photographs, video footage and other images for the purposes listed above.