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Tapestry Care Referral Form

Referral Information

Identity

Demographic

Reasons for Referral

Day Centre Information

Medical Information

Address

Contact

Consent

It is Tapestry Care policy to seek and obtain explicit consent from the individual concerned about any personal data collected and held about them in line with data protection requirements. 

If the individual lacks mental capacity, and has appointed an attorney under a lasting or registered enduring power of attorney to manage their affairs, Tapestry Care will seek to obtain explicit consent from them to make a best interest decision on behalf of the individual concerned.

Tapestry Care understand under the controller of personal information, we are responsibly for how that data is managed. The General Data Protection Regulation sets out our obligation to you and your right in respect of how we manage your personal information.
Full terms and conditions of this agreement:
I understand that the images taken of me will be added to the Tapestry photo library for use in promoting its activities and principles. Images may be used by Tapestry and its partners, including the media.
I understand that the photographs/recordings may be used in a variety of forms including but not restricted to: publications, media promotions, leaflets, advertising, websites and reports. I understand that the general public worldwide may see these photographs / hear these recordings.
I am aware that the images taken of me will be held in the Tapestry photo library indefinitely. I can ask for the images in which I appear to be removed from the library at any time by contacting the Communications Department. Although appropriate steps will be taken to remove images on request, I understand that it may not be possible to stop their use completely.
I hereby give informed consent for photographs/recordings to be taken of me and used by Tapestry as established above. I know I will not be paid for allowing the images to be taken or used.

I have read the Terms and Conditions above and hereby permit Tapestry to take and make available for publishing photographs/recordings of me. These images/recordings can be used in a variety of formats as deemed fit by Tapestry and partner organisations to promote the organisation as it sees fit.