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Templates / Form

Client Consent and Information Sharing Record

A plain-English record for noting consent, representatives, information sharing preferences, and review dates.

Prepared by CaresLink Editorial TeamEditable Word templateEmail required · link appears immediately

Example content

Preview the structure before opening the file

English structure excerpt · blank prompts, not a completed record

Client and representative
Client name · Representative name
Consent preferences
Information that may be shared · People or organisations allowed
Record keeping
Explained to client · Client questions
Read all template prompts
Client and representative: - Client name: - Representative name: - Relationship: - Authority or consent basis: - Review date: Consent preferences: - Information that may be shared: - People or organisations allowed: - Preferred contact method: - Limits or exclusions: Record keeping: - Explained to client: - Client questions: - Staff member: - Signature or confirmation: - Storage location:

Who it is for

Providers and coordinators recording client consent and communication preferences.

When to use it

Use at onboarding, when representatives change, or before sharing information with family or other services.

What this template helps with

A clearer record trail for everyday follow-up

Clear worker notes
Consistent records
Easier follow-up

Review notes

This template is a plain-language operational starting point. Check its fields, wording, and internal consistency before using it in a provider's own documentation system.