YLab x VicHealth | Reclink Youth Engagement Interview Consent Form

This is a consent form for Reclink staff participating in interviews to understand and document the ways you have been engaging and consulting with young people through the Future Active program. If you have any questions or need relating to this, please contact Lorraine Roberts via lorraine.roberts@ylab.global.

Consent

My story, image and voice is my own and I give permission to the Foundation for Young Australians (FYA) to collect information about me as part of YLab and VicHealth's 'Understanding Reclink's Approach to Youth Engagement' project by:

Interviewing me online
Taking an audio recording of me
Taking video footage / film of me

Please type your initials to accept FYA's collection of your personal information.(Required)

Use and Sharing

I decide how other people use and share my story, image and voice. I agree that the information collected from me may be used by FYA:(Required)

For activities related to YLab and VicHealth's 'Understanding Reclink's Approach to Youth Engagement' project.

I agree that the information collected from me may be shared:(Required)

With VicHealth and Reclink, de-identified and in summary form.

Privacy

More information about how FYA collects, uses, stores and discloses personal information, and how you can correct or make a complaint about how we have handled your personal information, can be found in our privacy policy: fya.org.au/privacy

Please type your initials to confirm that you understand that your information will be managed in a way consistent with FYA’s privacy policy.(Required)

First Name(Required)

Last Name(Required)

Date(Required)