Lekota will work closely with other agencies to coordinate the best support for me. This means My informed consent for the sharing of information will be sought and respected in all situations unless:

*We are obliged by law to disclose My information regardless of consent or otherwise if authorised by law.

*It is unreasonable or impracticable to gain consent or consent has been refused; and

*The disclosure is reasonably necessary to prevent or lessen a serious threat to the life, health or safety of a person or group of people.

By signing this document I acknowledge and agree that Lekota has advised me of the following:

Lekota Privacy and Confidentiality Policy and Procedure;

My right to access My personal information; and

My right to withdraw My consent at any time.

I understand that the following service(s) are recommended - Health professionals, Pharmacy; Medical specialists etc that relevant information about me may be received or forwarded to the agency(s) that provide these services, in order that I receive the best possible service: 

I understand that Lekota may collect, store and use the information collected from the services above:

I understand that Lekota must comply with relevant privacy laws, and I will contact the organisation immediately if I feel that these laws have been breached.

Lekota has discussed with me, and I understand that Lekota may mak recordings or take photos of me during the time my service is being provided.

Lekota has discussed with me how and why certain information about me may need to be provided to other service providers.

I understand the information in this document and I give my consent for my information to be shared within th manner detailed above.