Registration Form

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The following is GDPR consent and is legally required for you to access our services.

Completion of the GDPR will take approximately 5 minutes. It is a separate form that we have included here in order to make it as seamless and simple as possible. However, this means that some basic information you have already provided, will be asked of you again. We apologise for this as we know it can be frustrating, however we hope you understand that doing it this way is a requirement of us, and hopefully makes it easier for you.
Thank you

Privacy Notice – How we use your information
We are a service that provides information, advice and support to unpaid carers of all ages in Solihull. To be able to carry out work we are required to hold up to date personal information about you and your cared for. We hold all the identifiable information you share with us and records of activity you undertake with us.

Please be advised that we hold any information shared on this form on our database. We will use contract details you’ve provided to us to keep in touch with you regarding support available to you from Carers Trust Solihull.

Important
In line with the Data Protection regulations that came into force in May 2018 we will never share identifiable information without your consent, including names, contact details, bank details or medical information (exceptions to this apply below). The only other exception to this would be if somebody is at risk of significant harm to themselves or others, or for the prevention and detection of fraud and/or other crimes or as the law requires. You can request to see information we hold, in writing. To comply with GDPR and Safeguarding requirements we will securely retain your information for a minimum of 25 years.

However, as a service provider of Solihull Council, for parent carers, we share your assessments and support plans with SMBC, plus minimal information that enables them to identify you. This is to ensure their records are kept up to date and to help them identify services or benefits you may be entitled to or interested in. For information about how Solihull Council will use your information refer to the Council’s Privacy Statement on http://www.solihull.gov.uk

To comply with GDPR and Safeguarding requirements we will securely retain your information for a minimum of 25 years.

Privacy Notice – How we use your information
Although we minimise information we hold, paper documents will be kept securely locked and our data management system (Charity Log). This system is securely password protected. We also securely hold bank details for adult carers eligible for direct payment only. This information is kept confidential and used to support our work with you. For more information on Data Protection – contact our office on 0121 788 1143.

Who and how is it shared?
We are required to submit monitoring forms to funders (outside of SMBC) about our work with carers. We will never share personal information or in any way identifies you or the person who requires care to these funders. To maximise support for you, we may also share information with other professionals about your engagement, only in your best interest and with your consent.

Solihull Council and Other Funders
As we are funded by the Solihull Council and other funders to deliver services for carers, we have to submit unidentifiable statistical information to show how we have used those funds for the benefit of carers.

Liquid Logic Social Services Database
Carers Trust Solihull (formerly Solihull Carers Centre) is funded to carry out Carers Assessments on their behalf of Solihull MBC. If you request an assessment all this information including your cared fors’ name and address will be stored on the social services database and our Carers Trust Solihull database but will be allocated to our teams.
• Completion of this consent form is required for you to receive services from us • You have the right to withdraw your consent at any time by contacting us at our offices - contact details below • Our Data Protection Officer is Brandon Scott-Omenka CEO

Carers Trust Solihull Contact Details
Carers Trust Solihull, Solihull Fire Station Annexe, 620 Streetsbrook Road, Solihull, B91 1QY
Website: http://www.solihullcarers.org
Email: centre@solihullcarers.org
Telephone: 0121 788 1143
CHARITY NO. 1092613

SECTION 3: EMERGENCY CONTACT
For Events and Trips.
Please note: This CANNOT be the person(s) you care for.

SECTION 4: INFORMATION SHARING

SECTION 5: MEDICAL ATTENTION

SECTION 6: IMAGES AND VOCAL

SECTION 9: PLEASE INDICATE YOUR RELIGION

SECTION 10: PLEASE INDICATE YOUR GENDER

SECTION 11: IS YOUR GENDER IDENTITY THE SAME AS THE SEX YOU WERE REGISTERED AT BIRTH?

SECTION 12: PLEASE INDICATE YOUR sexual orientation

• the person(s) that require(s) care – i.e. the CARED FOR
• or by the parent/guardian of a child under 18 that requires care
• or on behalf of someone who requires care – with their permission

For the person named above to access our services we are required to hold the following information about the Person(s) Who Requires Care (Cared For).

THIS SECTION TO BE COMPLETED BY:
• the person(s) that require(s) care – i.e. the CARED FOR • or by the parent/guardian of a child under 18 that requires care • or on behalf of someone who requires care – with their permission

For the person named above to access our services we are required to hold the following information about the Person(s) Who Requires Care (Cared For):

THIS SECTION TO BE COMPLETED BY:
• the person(s) that require(s) care – i.e. the CARED FOR • or by the parent/guardian of a child under 18 that requires care • or on behalf of someone who requires care – with their permission

For the person named above to access our services we are required to hold the following information about the Person(s) Who Requires Care (Cared For):

Carers Trust Solihull relies on up-to-date personal details to ensure each person receives relevant information and support from the service. I understand it is my responsibility to inform Carers Trust Solihull of any changes to my personal details or if there has been any significant change to my caring role.

Carers Trust Solihull relies on up-to-date personal details to ensure each person receives relevant information and support from the service. I understand it is my responsibility to inform Carers Trust Solihull of any changes to my personal details or if there has been any significant change to my caring role.