Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters.

Client Consent Form



Your details
(This question is mandatory)
Please enter your
(This question is mandatory)

date of birth:

Privacy, rights and responsibilities

In the following circumstances, information may be collected or disclosed without prior cosnent: 

  • Emergency situations where you or someone else are at  risk of harm;
  • Situations where a minor may be at risk of harm; or
  • When your information is requested as part of legal proceedings.
Your rights

Access to your file
To access, submit a request in writing detailing the information you would like to obtain. 
Note: Sonder does not provide medical/legal reports (i.e. for Family Court or Criminal Court). 

Feedback/change of worker
Contact Sonder by email/phone to provide any feedback or to request a change of clinician/worker. You can also submit anonymous feedback via our website. 

Withdraw consent
Sonder is a voluntary service. You can withdraw your consent at any time. 

How we handle your personal information

Privacy, collection and storage
Consent is required before treatment can commence. Sonder collects clients' information (personal and health related) to make sure we deliver the best possible care. 
We will maintain your privacy and confidentiality by storing your information securely in an electronic database or locked file cabinets. We will avide by the Australian Privacy Principles and our Privacy Policy at all times. 

Evaluation and reporting 
We collect statistical information to meet our funding requirements and for internal evaluation to improve our services. Unless stated otherwise, this is non-idenitifable and will not identify clients in any way. De-identified data may also be shared with the Dept of Health.

Information sharing (e.g. GPs, 3rd parties)
For clients referred by their GP with a Treatment Plan (e.g. Mental Health/Chronic Disease/GP Management), we are required to send brief progress reports back to the GP.
For clients referred primarily for care coordination, we are required to communicate and exchange information with other parties to organise approprirate delivery of care. 
If there are additional third parties involved in your care who we need to communicate with, the Consent to Share Information Form must be completed.  

Our communication with you

Sonder uses SMS as our main method of communication.

Client experience survey
Client experience surveys are sent to all clients who have accessed a Sonder program within the last 6 months (including emerge clients bt excluding headspace clients). Surveys are sent in December and June each year. Completing the survey is voluntary. 

In the same way that clients will receive respectful, professional service from Sodner staff, clients are also expected to treat staff members with respect. Aggressive and abusive behaviours will not be tolerated. 
Information given:

To be completed ONLY by programs that use MasterCare

Consent for:

Information stored in shared platform
Anonymised client data

Information stored in shared platform
Personal clinical information will be stored in MasterCare shared platform hosted by the Primary Health Networks. If the client does not consent to use this sytems, they can elect to use a pseudonym (a name someone uses instead of their real name). 
If this is not acceptable, Sonder can make provisions to have the client's data stored on a seperate electronic platform.

Anonymised client data
If the client does not wish for their de-identified statistical information (AKA anonymised data) to be sent to the Department of Health, they may opt out. 

By marking below you agree: 

  • That the above items have been discussed with you; and
  • To proceed with the services provided by Sonder in accordance with the conditions discussed.