KBOP Referral form
Please Fill in the form Below
Consent and Client Declaration Information – KBOP Please read out in full to the applicant
To be able to process your referral, we need to record, store and process details about your needs, housing and support. This may contain your personal data, and includes “special category data” such as information about your health, ethnicity, religion etc.
We ask for this information so that we can make a decision about whether our service is the best one for you, or whether there is a more suitable service elsewhere. We also use the special category data for monitoring purposes, to make sure our services are fair and easy to access, and to meet funding requirements. We will record your personal data on our secure electronic system and also on paper.
You don’t have to answer any question that you do not want to, and you should let us know if you don’t want to give us some of the information we ask for. However, this may affect our ability to provide you with an appropriate service.
We may contact other professionals and agencies who have knowledge of you currently or in the past (e.g. Health / Housing Professionals, Police, Probation). This is so we can get additional information about your needs, and so we are aware of any risks (e.g. Police check, landlord reference).
Further information can be found in our Client Privacy Notice, which is available on request or can be downloaded from our website
Declaration – Please ask the client to confirm the following;
- You authorise Kirklees Better Outcomes Partnership to process your personal information for the reasons explained
- You confirm that the information you provide will be correct and true to the best of your knowledge
- You understand that your information may be shared with other agencies / professionals as previously explained
- You acknowledge that you have been made aware of the Client Privacy Notice, which explains how your personal details will be managedConsent questions
- Consent to hold uploaded files and process your data
- Consent to include data in reporting
- Consent to include data on secure test systems
- Consent to share data with regulatory bodies – (i.e organisations in KBOP)
- Consent to share data with essential partners – (i.e WYP, social care)