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Information Collection Consent Form

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Information Collection Consent Form

Revised 18/7/13

WHAT YOUR PERSONAL INFORMATION IS

Personal information is any information or an opinion (whether true or not) about you. It may range from the very sensitive (e.g. medical history or condition) to the everyday (e.g. address and phone number). It would include the opinions of others about your work performance (whether true or not), your work experience and qualifications, aptitude test results and other information obtained by us in connection with your possible work placements. Personal information includes sensitive information.

WHAT SENSITIVE INFORMATION IS

Sensitive information is a special category of personal information. It includes information or opinion about your:

• membership of a professional or trade association or membership of a trade union;

• criminal record;

• health or disability (at any time);

• It includes personal information collected to provide a health service.

There are other types of sensitive information; but they are generally less relevant to work and pre-work situations. Sensitive information can, in most cases, only be collected with your consent. We will only collect information that is necessary for the proper performance of our tasks or functions. We do not collect or use personal or sensitive information for the purposes of unlawful discrimination.

WE WILL NEED TO COLLECT PERSONAL INFORMATION ABOUT YOU

Personal information may range from the sensitive (e.g. relevant medical history or criminal history) to the everyday (e.g. address and phone number). We may collect the opinions of others about your work performance your work experience and qualifications, aptitude test results and other information in connection with your possible work placements.

We will only collect information that is necessary for the proper performance of our tasks or functions. We do not collect or use personal information for the purposes of unlawful discrimination. We do not collect personal information just because we think it could be useful at some future stage if we have no present need for it. We do not routinely conduct criminal history checks and only do so in order to obtain relevant criminal history with regard to particular jobs you are offered or for which you are shortlisted. If you only browse our website, we do not collect information that identifies you personally, though we may collect information related to your visit to our website.

WHO WILL BE COLLECTING YOUR PERSONAL AND SENSITIVE INFORMATION

Your personal information will be collected by DFP Recruitment Services for its own use and on behalf of other members who might require access to your personal and sensitive information in connection with your work placements.

Your personal information will be held by DFP Recruitment Services. Some of your personal information may be held on portable devices such as mobile phones, laptop computers or in diaries operated and held by our staff members.

HOW YOUR PERSONAL INFORMATION WILL BE COLLECTED

Personal information will be collected from you directly when you complete and submit one of our registration forms or provide other information in connection with your application to us.

Some sensitive information may be recorded as a result of you providing legal documents, e.g.: your passport or proof of entitlement to work in Australia.

Personal Information will also be collected when:

• we receive any reference about you

• we receive results of inquiries that we might make of your former employer, work colleagues, professional associations or registration body

• we receive the results of any competency or medical test

• we receive performance feedback about you (whether positive or negative)

• we receive any complaint from or about you in the workplace

• we receive any information about a workplace accident in which you are involved

• we receive any information about any insurance investigation, litigation, registration or professional disciplinary matter, criminal matter, inquest, or inquiry in which you are involved, and

• you provide us with any additional information about yourself.

LEGAL REQUIREMENTS FOR PERSONAL INFORMATION

Some laws such as taxation law, immigration law, laws regulating employment agencies, laws relating to national security, laws relating to professional or trade registration and laws for the protection of certain classes of people (such as children or the elderly) may require that we collect certain types of information (including criminal history) from you that is relevant to the position/s for which you may be applying. There may be cases where our duties of care or contractual duties require us to obtain and disclose certain types of personal information relevant to specific jobs.

When requesting information of this type we will tell you whether the supply of that information by you is mandatory or voluntary.

IF YOU DO NOT GIVE US ALL OR PART OF THE INFORMATION WE NEED

• we may be limited in our ability to locate suitable work for you;

• we may be limited in our ability to place you in work;

• we might decline to represent you in your search for work or put you forward for particular positions.

YOUR PERSONAL INFORMATION WILL BE USED IN CONNECTION WITH

• our assessment of your suitability for registration with us;

• the necessary validation (including from appropriate third party sources) of your resume, v.v., nominated references, or stated qualifications, experience, training or abilities. Where we require third party validation we will tell you how we propose to obtain it;

• your actual or possible work placement

• your performance appraisals our assessment of your ongoing performance and prospects

• any test or assessment (including medical) that you might be required to undergo

• our identification of your training needs

• any workplace rehabilitation in which you and we are involved;

• our management of any complaint, investigation or inquiry in which you are involved, and

• any insurance claim or proposal that requires disclosure of your personal or sensitive information

• suggestions we may make to you, whilst you remain registered with us, for further training in connection with work of the type that you are seeking through us;

• any reference that we may give concerning your work;

• our statutory compliance obligations;

CONSENT TO COLLECTION, USE AND STORAGE OF PERSONAL INFORMATION BY DFP RECRUITMENT SERVICES PTY LTD

I (full name) of (address)

have read and understood each of the statements in the Collection Statement and Consent to Electronic Transactions and have had sufficient opportunity to read and understand your Privacy Policy. I voluntarily consent to:

• personal and sensitive information about me being collected by you as indicated above;

• personal and sensitive information about me being used as indicated above;

• personal and sensitive information about me being disclosed as indicated above;

• engaging in electronic transactions with regard to any matter connected with the purposes for which my personal information may be used or disclosed as indicated above.

I am happy to receive any e/mail from DFP as part of their ‘Keep in Touch’ program.

I have permission to work in Australia. If you are invited into DFP Recruitment Services for an interview you will need to supply proof of eligibility to work in Australia eg. birth certificate or passport or passport & working visa (if applicable). Please note if you have changed your name you will need to bring documentation to support this eg. marriage certificate along with supporting photo identification if you are supplying a birth certificate.

Date

Signed

dfp Commercial dfp Contact Centre dfp Government dfp Health dfp Industrial dfp Resources

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What the Information Collection Consent Form Is

An Information Collection Consent Form documents an individual’s permission for an organization to collect, use, store, or share specified personal data. It clarifies the categories of information collected, the purposes for which data will be used, retention timelines, and any third parties that may receive the data. For consumer-facing processes, the form also records consent method and date to create an auditable record. Properly executed consent forms help organizations meet legal requirements for electronic consent and provide a clear record of the subject’s choices.

Why a Clear Consent Form Matters

A clear consent form reduces legal uncertainty, documents individual choices, and supports compliance with ESIGN and state electronic signature laws. It also improves transparency for data subjects and creates a defensible audit trail that helps meet obligations under HIPAA, CCPA, and sector-specific rules.

Why a Clear Consent Form Matters

Who Typically Prepares or Signs This Form

The form is appropriate for any data controller or service provider that needs a written record of a data subject’s affirmative agreement.

  • HR and recruiting teams collecting employment candidate and employee records for onboarding and background checks.
  • Healthcare providers capturing patient authorization for treatment, releases, and data sharing under HIPAA.
  • Schools and education administrators collecting parent or student consent for records and directory information.

Primary Signers and Preparers

Data Subject

The individual whose personal information is being collected; must sign or provide verifiable electronic consent and be able to withdraw consent where permitted by law.

Data Controller

The organization collecting data or an authorized representative who completes the form details, records the purpose of collection, and maintains the audit trail for compliance and recordkeeping.

Essential Elements to Include in the Form

A professional Information Collection Consent Form balances clarity with legal precision so signers understand scope, purpose, and rights.

Consent Statement

A concise declaration that the signer consents to the specified data collection and processing activities and agrees to the described purposes.

Data Categories

A clear list of the types of personal information being collected (e.g., contact data, identifiers, health information) to set scope.

Purpose of Use

Explicitly state why the data is collected and how it will be used, including any automated decision-making or profiling.

Third-Party Sharing

Identify categories of recipients and whether data may be sold or transferred to partners, processors, or affiliates.

Retention Period

Specify how long the data will be retained or the criteria used to determine retention, with reference to applicable law where relevant.

Withdrawal and Contact

Explain how the signer can revoke consent, and provide contact information for the data controller or privacy officer.

Security and Compliance Checklist

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Audit Trail: Timestamps, IP, and action history
Access Controls: Role-based access and logging
Certifications: SOC 2 Type II, ISO 27001
HIPAA Support: BAA available where required
Retention Controls: Configurable retention and export

Step-by-Step: Completing the Consent Form

Follow these steps to ensure the form is complete, enforceable, and auditable when collected electronically.

  • 01
    Prepare the Form: Draft clear purpose, data categories, retention, and contact details.
  • 02
    Add Consent Fields: Include required checkboxes, signature, and date fields.
  • 03
    Choose Authentication: Select email, SMS code, or stronger methods for signer verification.
  • 04
    Capture and Store: Record the signed copy and audit trail in secure storage.

Configuring an Online Consent Workflow

Set up the workflow to capture consent reliably, preserve evidence, and automate routing to the right records systems.

Field Configuration
Consent Checkbox Required field with required text visible before submit
Signature Field Capture signature and date; attach audit trail
Authentication Email link plus optional SMS code for stronger proof
Storage Save signed PDF and metadata to secure archive

Digital Signing and Submission Requirements

Ensure the platform can issue a certificate of completion, support retention policies, and provide a BAA if HIPAA applies.

  • File Formats: PDF, Word DOCX, HTML supported
  • Integrations: Salesforce, NetSuite, Google Workspace, Microsoft 365
  • Authentication Options: Email link, SMS code, KBA, SSO

Where to Send or File the Completed Form

Route the signed form to the appropriate records owner and any required third parties, and store a copy in systems of record.

  • Data Controller: Primary recipient for storage and policy enforcement
  • HR or Medical Record: Attach to employee or patient file as applicable
  • Third-Party Processors: Share only with documented processors under contract
  • Archive: Store signed record and audit trail in secure archive

Key Timeframes to Note

Certain actions and responses tied to consent have time expectations; align your processes to these common timelines.

Disclosure Before Collection:

Provide electronic disclosure and obtain consent prior to collecting the data

Acknowledgment of Consent:

Send signed confirmation to the subject promptly after collection

Revocation Handling:

Acknowledge revocation and update processing within 30 days where law applies

Access Request Response:

Handle data access requests per applicable law, commonly within 30–45 days

Retention Review:

Review retention schedules annually or upon regulatory change

Common Mistakes When Preparing the Form

  • Using vague purpose language that fails to explain how data will be processed or shared, which undermines informed consent.
  • Omitting withdrawal instructions or making revocation onerous, creating legal and customer-service complications.
  • Failing to capture an audit trail with timestamp and signer attribution, weakening evidentiary value of consent.
  • Not matching the name on the form to verified identity, creating problems with later disputes or legal reliance.

Risks of an Incorrect or Missing Consent

Regulatory Enforcement: Administrative fines and corrective actions
Civil Liability: Private suits or class actions
HIPAA Exposure: Potential civil and criminal penalties
Contractual Breach: Damages and indemnity obligations
Operational Disruption: Forced suspension of processing activities
Reputational Harm: Loss of customer trust and business impact

eSignature Pricing Comparison for This Form

Compare common pricing and feature dimensions for eSignature vendors. signNow appears first to reflect plan and capability details below.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Real-World Examples of Use

Organizations across sectors use electronic consent forms to speed intake and document permissions while maintaining compliance.

Fertility Centers of Illinois

John Butler reported streamlined approvals for patient intake forms and centralized records.

  • The team gained faster turnaround on patient authorizations.
  • The signed electronic records integrated with clinical workflows and preserved audit trails for compliance and operational efficiency.

Martin Properties

Tim Martin uses online consent for tenant screening and disclosures.

  • Tenants sign remotely during the application process.
  • The result was fewer in-person steps, consistent disclosures, and an auditable consent record tied to each application.

Frequently Asked Questions

Answers to common questions about legal validity, revocation, electronic capture, and practical handling of consent forms.


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