Consent to Share Information

This consent allows Plan Guard Plan Managers (Plan Guard) to share your personal and plan information with someone other than you such as yourfamily or friends, your support coordinator, your support workers, your therapist, your doctor etc. This could be over the phone or via email and/or on Plan Guard online platforms. This information will only be shared with the person/s you list below.

Only you (Plan Guard participant) or your authorised representative / nominee may give consent to share your personal and plan information.

The information we share can include your current funding amount, details about recent invoices, providers, and services that you have engaged and personal and contact information of you or your nominated representative.

Giving additional parties consent to access your personal information is entirely upto you and will not affect our services to you. You have the ability to add or remove people to your Consent to Share list in the future.

give consent for Plan Guard sharing information about my/the NDIS plan with the following parties

Additional Contacts/Service Providers

Additional Contacts/Service Providers

I declare that I have the authority to approve this consent to share information form, in my
capacity as:

NDIS Participant/ Parent of the NDIS Participant, who is under 18 y/o

A Guardian / Authorised Representative / Nominee of the NDIS Participant

Signature (of participant or authorised representative / nominee)

You may revoke these permissions at any time by sending an email to pm@planguard.com.au