Sensible Care

Consent

Consent & Authorisation

ConsumerCarerAdvocateRepresentative

consent to information relevant to the care I receive being made available as outlined below:

Doctor / GP / Specialist

Information can be obtained from

YesNo

Information can be provided to

YesNo

Aged Care Assessment Service

(ACAS)

YesNo

Family Member / Next of Kin

YesNo

Relevant Information may be shared with other team members involved in my care

YesNo

Other

(i.e. Hospitals, specialists, etc.)

Please specify

Information can be obtained from:

YesNo

Information can be provided to

YesNo

Other Service Providers

Please specify

YesNo

Care Finder Platform (Self-Managed Clients)

I consent to Share Care Finder Profile: I consent to sharing my existing care finder profile with Sensible Care for the purpose of receiving care worker details and compliance documents from Mable Platform or any other such platforms. I understand that this information will be used to facilitate my care services.

I consent to Sensible Care Creating a Profile on my Behalf: I consent to Sensible Care creating a profile for me on my behalf. This profile will be used to receive care worker details and compliance documents from Mable Platform or any other such platforms to facilitate my care services.

I understand that I have the right to withdraw this consent at any time by providing written notice to Sensible Care. Withdrawal of consent may affect the availability of care services through Sensible Care.

Acknowledgement

Consumer / Representative Acknowledgement

Who is acknowledging the agreement?

ConsumerRepresentative

Consumers Name

Consumers Signature

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Date

Representative Name

Representative Signature

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Date

Sensible Care Representative Acknowledgement

Sensible Care Representative Name

Sensible Care Representative Signature

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Date

Sensible Care Representative Email *

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