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I understand that the information on this form will be held on a secure database by Hart Gables for the purpose of monitoring progress and outcomes for service users.

I consent to the sharing of information recorded, where appropriate, with other support services, always with prior discussion and permission.

I understand that I can withdraw my consent at any time and have the right to access information held on me (which may incur a fee).

If any data is inaccurate, I have the right to have records amended and, in certain circumstances, deleted. If I think there is a problem with the way Hart Gables is handling information, I can complain to the Information Commissioner’s Office (ICO) via their website at ico.org.uk/concerns.

I understand that expressing the intent to harm myself or others, or giving information that someone is harming me, constitutes a safeguarding risk and requires Hart Gables to share relevant information with emergency or crisis services.

I agree to the Hart Gables Service User Code of Conduct (below).

If you have any questions about how we store and use your information please contact us on 01642 675509, or email us at info@hartgables.org.uk.
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