Agreement of Conditions of Service and Parental/Guardian Consent

Agreement of Conditions of Service and Parental/Guardian Consent

Speech and Language Development Australia (SALDA) is operated by CHI.L.D. Association.

In referring your child to SALDA for services, I/we acknowledge that:

  1. I give permission for SALDA to visit my/our child at his/her school for the purpose of an advisory visit. I give permission for the relevant documents and information to be released by the school to SALDA to enable SALDA to provide a service. (Please refer to Privacy Notice below).
  2. SALDA staff may create written records, photos, video or audio recordings of my/our child and use these in preparing their consultations and recommendations with parents, educational and therapy personnel or other professionals. All records will remain the property of SALDA as medico-legal documents and may subsequently be used for research and/or professional education purposes. The confidentiality of these records will be respected at all times and no use will be made of them for general publications without further consent being sought.
  3. SALDA staff may contact persons who are or have been directly concerned with the care or education of the child (such as teachers, therapists, and doctors) to seek information about the child’s background, abilities and performance that may be relevant to the service being provided. Written reports or accounts may be requested.
  4. SALDA staff may use the results of any relevant information available to assist in consulting with the educational personnel and other professionals involved with the child, with the intent of supporting and improving educational outcomes.

By submitting the form, I confirm that:

  • I have read and understood the information provided about the School Support Services visit and therequirements outlined for access to, sharing and storage of information.
  • I agree to my/our child being involved in the intervention program, if applicable.
  • I understand that an individualised report will be provided to the education setting following the visit and will subsequently be forwarded to me/us (legal guardian/s) by the education setting.
  • I have legal custody of the above-mentioned child and the legal authority to complete this document; I have provided any relevant custody documentation, where applicable.

I/we hereby exempt Speech and Language Development Australia, its officers and employees from any liability or loss that may result from findings, opinions or recommendations expressed by SALDA staff in relation to the child, and from any liability for any physical injury that may occur to the child whilst under the supervision of SALDA staff, on the condition that those staff act conscientiously in accordance with the practices and duty of care normal to their professions.

Privacy Notice

Personal and sensitive information collected on this form will be retained and used for the purpose of providing Speech and Language Development Australia services and to meet our requirements for government funding. It may also be used for other purposes such as to monitor and evaluate existing services and plan for future services or for research purposes. Without this information SALDA may be unable to provide you with its service. The information collected on this form will only be used by SALDA and will not be disclosed to any other person or organisation unless we have your authorisation. Please refer to SALDA Privacy and Confidentiality Policy at SALDA.org.au or phone 1300 881 763.

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