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CONSENT TO TRANSFER INFORMATION

Student Details

First name:

School Transfer Details

Current School

New School/Catholic Education Commission of Victoria Ltd (CECV)

The teacher/principal has discussed with me/us how and why certain information about my child is provided to the new school. I understand that in addition to formal reports etc. details regarding the educational program will be supplied.

I/We provide informed and express consent for all relevant health and/or educational information held by school A, detailed below, to be provided to school B. I understand that this information will be collected and used by St Augustine's College to inform health and safety management strategies and educational programming for my child. 

Type of Information

(e.g. personalised learning plans/student program, medical reports, specialist notes, information regarding adjustments, medical management plans, attendant care plans, behaviour support plans, safety plans)
Do you have more information to share* - required
More Information to Share
Date
Author e.g. psychologist, medical practitioner's name
Title (e.g. speech pathologist, psychologist, paediatriatrician)
Description (e.g. cognitive assessment, language assessment)

Consent

Parent/Guardian name
Parent/Guardian name

Please type your signature

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Please type your signature

Please sign here

Please refer to each school's information about their use and disclosure of information, and information regarding their privacy policy. Further clarification is available on request for the principals.
Mandatory field(s) marked with *

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