I the client confirm the consent to disclose information has been discussed with me. I have been informed Poutini Waiora is bound by law to uphold the Health and Disabilities Act; the Oranga Tamariki Act; and the Family Violence Act which means if kaimahi believe or witness there is harm to self and / or others this will be reported to the appropriate authorities. By signing this agreement I give consent to services being provided to me by Poutini Waiora including transport.I also give written consent to Poutini Waiora to gather the required information that links me and whanau to the right service. I accept by signing this consent I give permission for Poutini Waiora to contact any relevant service provider, NGO or government service to do this.I understand that any information gathered about me and whanau will be stored safely and my privacy will be respected by Poutini Waiora.