Grow Perform Consent Form

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As part of providing a comprehensive psychological service to you, personal information that is relevant to your current situation will be collected from you and recorded. This information is gathered to assist in provision of performance coaching services during your time with Grow Perform.

 

Purpose of collecting and holding information

The information is gathered as part of the performance coaching process, is kept securely and, in the

interests of your privacy, used only by the psychologist with coaches and support team (as necessary). The information is retained to document what happens during coaching, and enables the psychologist to provide a relevant and informed service. A more detailed description is provided in the practice’s “Privacy policy for management of personal information”, which can be obtained by contacting Grow Perform Director lana@lanaireland.com. The Privacy Policy contains information about how to access and seek correction of your personal information, and how to lodge a complaint about management of your personal information.

 

Consequence of not providing personal information

If you do not wish for your personal information to be collected in a way anticipated by this form or the Privacy Policy, Grow Perform may not be able to provide the service to you.

 

Access to client information

At any stage you are entitled to access your personal information kept on file, subject to exceptions in the relevant legislation. The psychologist may discuss with your different possible forms of access.

 

Disclosure of personal information

All personal information gathered by the psychologist during the provision of the service will remain

confidential except when:

1. Failure to disclose the information would in the reasonable belief of Grow Perform place you or

another person at serious risk to life, health, or safety; or

2. Information is subpoenaed by a court, or if disclosure is otherwise required or authorised by law; or

3. Your prior approval has been obtained

 

Your personal information is not disclosed to overseas recipients, unless you consent, or such disclosure is otherwise required by law. Your personal information will not be used, sold, rented, or disclosed for any other purpose. If unauthorised access, disclosure, or loss of a client’s personal information occurs, Grow Perform will activate its data breach plan and use all reasonable endeavours to minimise any risk of consequential serious harm.