Free template · consent
Consent form template for sharing participant information.
Consent the way the Practice Standards describe it: what you collect and why, who you'll share it with and what for — one line each — when the law means sharing without consent, photos and recordings agreed separately, and how the person sees, corrects or withdraws it.
Who it is for: NDIS providers and support coordinators recording a participant's consent, with the participant or their representative.
No email, no sign-up. Checked against the rules on 15 October 2026.
What's in it
8 sections, built on the rules.
- 01About the participantParticipant name · NDIS number · Representative giving consent, if any
- 02What we collect, and whyInformation we collect · Why we collect it
- 03Who we may share it withSharing
- 04When the law means sharing without consentExplained to the participant on (date)
- 05Photos, audio and videoRecordings of the participant · Other uses agreed
- 06Storing, seeing and changing their mindHow we store it, and who can see it · How to see or correct their information · How to withdraw or change this consent
- 07How long it lasts, and how it was explainedConsent given on, and the date to review it · Explained by · Interpreter or support person present, if any
- 08SignaturesParticipant or representative: name, signature, date · Provider: name, role, signature, date · Copy given to the participant (date and format)
Consent to collect, use, keep and share — with the reason
Registered providers get each participant's consent to collect, use and keep their information and to share it — assessments included — with other parties, and say why each time.
NDIS (Quality Indicators for NDIS Practice Standards) Guidelines 2018, section 14 — legislation.gov.auWhen it's shared without consent
Participants are told the circumstances in which their information could be shared, including that it can be given without their consent when the law requires or allows it.
NDIS (Quality Indicators for NDIS Practice Standards) Guidelines 2018, section 14 — legislation.gov.auHow it's kept, and how to see, correct or withdraw
Participants are told how their information is stored and used, when and how they can see or correct it, and how to withdraw or change the consent they gave.
NDIS (Quality Indicators for NDIS Practice Standards) Guidelines 2018, section 14 — legislation.gov.auRecordings are agreed too, in words they understand
Each participant understands and agrees to what personal information is collected and why — audio and video recordings included — and is told about confidentiality in their own language and way of communicating.
NDIS (Quality Indicators for NDIS Practice Standards) Guidelines 2018, section 8 — legislation.gov.auReportable incidents are notified regardless
Registered providers must notify the NDIS Commission of reportable incidents, so information about one is shared with the Commission whatever the consent form says.
Reportable incidents — NDIS Quality and Safeguards CommissionThe template
Use it here, or take it with you.
Print it, save it as a PDF, or download the Word file and put your own name and logo on it.
Consent to collect and share information
Organisation: ______________________________
01 About the participant
Participant name
NDIS number
Representative giving consent, if anyTheir name, relationship, and their authority — plan nominee, guardian, parent of a child.
02 What we collect, and why
Information we collect
- Contact details
- NDIS plan details
- Health information
- Assessments and reports
- Notes about the supports we provide
Why we collect itFor example: to plan and deliver your supports, to claim payment, and to keep you safe.
03 Who we may share it with
One line for each person or organisation — consent is given for each one.
Sharing
| Who | What information | Why | Agreed (yes or no) |
|---|---|---|---|
04 When the law means sharing without consent
Some information has to be shared whatever is ticked above — for example, registered providers notify the NDIS Commission of reportable incidents.
Explained to the participant on (date)
05 Photos, audio and video
Recordings of the participant
- Not at all
- For their records only
- For the uses written below
Other uses agreedFor example: a newsletter, training material. Name each one.
06 Storing, seeing and changing their mind
How we store it, and who can see itWhere it's kept, who has access, and how long it's kept.
How to see or correct their informationWho to ask, and how long it takes.
How to withdraw or change this consentAt any time — who to tell, and how.
07 How long it lasts, and how it was explained
Consent given on, and the date to review it
Explained by
- Reading it together
- Easy Read
- An interpreter
- Another format
Interpreter or support person present, if any
08 Signatures
Participant or representative: name, signature, date
Provider: name, role, signature, date
Copy given to the participant (date and format)
A free template to adapt — not an official form, and not legal or compliance advice. Corella is not affiliated with the NDIA or the NDIS Quality and Safeguards Commission. The rules behind it change, so check the current guidance and your own obligations before you rely on it. A free template from Corella — corellacare.com.au/templates/ndis-consent-form/
Filling it in
What makes it a good record.
One line for each recipient
Consent to share with a GP isn't consent to share with a family member. Give each person or organisation its own line, with what's shared and why.
Photos and recordings on their own
Ask about photos, audio and video separately from everything else, and name each use — a newsletter is a different question from the person's own records.
Say the exceptions first
Explain up front what has to be shared whatever is ticked, such as reportable incidents. It's easier to trust a form that says so.
Make changing their mind easy
Write down exactly who to tell. Consent can be withdrawn or changed at any time, and the form should make that simple to do.
Review it with the support plan
People, providers and preferences change. Look at consent again at each plan review, and whenever someone new needs the information.
A free template to adapt — not an official form, and not legal or compliance advice. Corella is not affiliated with the NDIA or the NDIS Quality and Safeguards Commission. The rules behind it change, so check the current guidance and your own obligations before you rely on it.
In Corella
The same record, kept for you.
In Corella, the office sees the whole record and a support worker sees the people they're rostered with, through their shifts — the need-to-know panel, the notes you share, the plan's tasks and the medications — while office-only notes stay in the office.
Fair questions
Before you use it.
Sources
Is there an official NDIS consent form for providers?
Does consent need to be in writing?
Can a representative give consent?
Can the participant change their mind?
What has to be shared even without consent?
Keep this record in one system.
See how Corella keeps the same record on the shift it belongs to — book a walkthrough, or try a live demo with a time-boxed pass.