Consumer Consent Form

As part of providing a mental health service to you, Stride needs to collect and record personal information from you that is relevant to your situation, such as your name, contact information, medical history and other relevant information as part of providing mental health services to you. This collection of personal information is a necessary part of the mental health assessment conducted and treatment that is provided.

Your informed consent will be obtained before any treatment or procedure is initiated and you may withdraw from treatment at any time. We also use your personal information to evaluate and report on the results of our services, improve our services and potentially offer you other beneficial services. If you are unclear about any of the information on this consent form, please discuss this with your service provider/worker.

Your personal information is gathered as part of your assessment and treatment. We collect this information directly from you where we can but in some cases, it may be necessary for us to collect personal information about you from a third party e.g. your GP, carer or guardian. This information may include your medical history and reports, information about other services you access and the frequency of those services and any medical diagnosis.

All information we hold about you is kept securely and, in the interests of your privacy, used only by your service provider / worker and authorised personnel of Stride as necessary for us to provide mental health services to you. We would like to emphasise that your privacy and the information that you provide to us, or that we collect from third parties about you, is protected at all times. Your personal information is retained in order to document what happens during interactions and enable the service provider / worker to provide a relevant and informed mental health service to you.

You are entitled to access and correct your personal information kept on file at any time. Should you wish to see the information kept on your client records, please discuss this with your service provider / worker. If you wish to obtain more information about how we collect, store and use your personal information you can access our privacy policy at https://stride.com.au/privacy-policy/

All personal information gathered by the service provider / worker during the provision of the mental health service will remain confidential except when:

1. It is subpoenaed by a court; or
   Failure to disclose the information would in the reasonable belief of Stride place you or another person at serious risk to life, health or safety; or
2. Your prior approval has been obtained to:
3. Provide a written report to another professional or agency. e.g. GP, school or a lawyer; or
4. Discuss the material with another person, e.g. a parent, employer or health provider; or
5. Disclose the information in another way; or
6. You would reasonably expect your personal information to be disclosed to another professional or agency (e.g. your GP) and disclosure of your personal information to that third party is for a purpose which is directly related to the primary purpose for which your personal information was collected; or
7. Disclosure is otherwise required or authorised by law.
8. When consulting with colleagues, or in the course of supervision, your service provider / worker will be required to conceal your identity and any associated parties involved; and to preserve your privacy in the utmost professional manner.

From time to time we may need to share your information with third parties as part of our service provision to you or to support our activities or to meet any obligations we may have (under contract or at law) to any health agency or organisation e.g. Primary Health Networks, including:

• To other service providers as part of providing a comprehensive package of services to you and for consistency of care; or
• In reports to our funding bodies about the people we support and the types of services we provide.

Aggregated, non-identifying information about the services Stride provides to its clients may be provided to external researchers for research or evaluation purposes.

If you do not wish for your personal information to be collected in a way contemplated by this consent form, Stride may not be in a position to provide the mental health service to you. You may request to be anonymous or to use a pseudonym, unless it is impracticable for Stride to deal with you or if Stride is required or authorised by law to deal with identified individuals. In most cases, it will not be possible for you to be anonymous or to use a pseudonym.