Consent to information sharing

Consent to information sharing.
To support your child or family in the best way possible it may be helpful for Downright Special to speak to other services from time to time. To do this we need to ask your permission. Permission lasts for the time we are supporting your child unless you tell us otherwise. You can withdraw permission at any time by notifying us in writing. E-mail office@downrightspecial.co.uk

Please note: In circumstances where we believe a child or vulnerable adult is at risk we have a professional and legal obligation to safeguard them by sharing information with other agencies without explicit consent however we would always attempt to seek consent even in these exceptional circumstances unless we believed doing so would place the child at further risk.
Child / Young person Name*

First NameLast Name
Child / Young person Date of Birth*

DayMonthYear
Date
Parent/guardian/carer name*

First NameLast Name
Email address*
example@example.com
Telephone (Home)

Area CodePhone Number
Mobile phone number*
Please enter a valid phone number.
Second Parent / guardian / carer name (if applicable)

First NameLast Name
Email address
example@example.com
Mobile phone number
Please enter a valid phone number.
I parent/carer consent to Downright Special staff sharing information with the following services on a proportionate and necessary basis to ensure my child is supported effectively.
NHS Services - For example to discuss progress and targets with Speech and Language Therapy. To seek advice about seating or positioning for the Friday sessions with OT/physio or to discuss a child’s progress on the Down Syndrome Care pathway with a Health Visitor.*

YesNo
Education - For example to do an outreach visit to your child’s nursery or school to discuss ideas for inclusion. To submit a report for your child’s annual EHCP review. To discuss behaviour strategies with school staff.*

YesNo
Social Care - For example to discuss your child’s current portage targets and progress with their portage worker or to seek advice about available support from the Early Help or Safeguarding Team.*

YesNo
I confirm I am the parent or legal guardian of any children named above*

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Date competed

DayMonthYear
Date
Should be Empty:

Consent to information sharing.

I parent/carer consent to Downright Special staff sharing information with the following services on a proportionate and necessary basis to ensure my child is supported effectively.