Consent to Exchange Information Form HiddenConfidentiality Policy and Consent to Exchange InformationInformation held by Big Brothers Big Sisters of London and Area (BBBSOLA) will not be disclosed to any person without written approval of said person except in the following cases: Where the safety of a child depends upon divulging this information. This could include suspicion of neglect or abuse of a child. The proper authorities will be informed when necessary, which could result in the disclosure of confidential information without written consent from the person; When subpoenaed by the courts; Where required by law. In the event that confidential information is requested to support custody or access application, or for any court matter other than a “child protection” case, BBBSOLA will only release the information if required to do so by a Judge’s Order. No staff member or volunteer shall use confidential information from the agency to advance any personal interest, financial or otherwise. In accordance with Big Brothers Big Sisters of Canada’s National Standards: No information will be provided to persons or organizations outside of Big Brothers Big Sisters of Canada, and its agents, about parents, children or volunteers without their express prior written consent except where required by law. All information and records, including electronic records, shall be kept secure (for example, in a filing cabinet, desk, etc. under lock and key, password protected, etc.) and confidential at all times. I understand that BBBSOLA may need to exchange information with others so that the Agency can understand the needs of the child and serve to meet those needs. I hereby consent to the exchange of information, at the discretion of BBBSOLA, with my child’s mentor throughout the matching process, as well as for the purpose of match supervision throughout their mentoring relationship. I also hereby consent to any exchange of information deemed appropriate regarding the child between Big Brothers Big Sisters of London and Area and;Information held by Big Brothers Big Sisters of London and Area (BBBSOLA) will not be disclosed to any person without written approval of said person except in the following cases: 1. Where the safety of a child depends upon divulging this information. This could include suspicion of neglect or abuse of a child. The proper authorities will be informed when necessary, which could result in the disclosure of confidential information without written consent from the person2. When subpoenaed by the courts;3. Where required by lawIn the event that confidential information is requested to support custody or access application, or for any court matter other than a “child protection” case, BBBSOLA will only release the information if required to do so by a Judge’s Order.No staff member or volunteer shall use confidential information from the agency to advance any personal interest, financial or otherwise.In accordance with Big Brothers Big Sisters of Canada’s National Standards: No information will be provided to persons or organizations outside of Big Brothers Big Sisters of Canada, and its agents, about parents, children or volunteers without their express prior written consent except where required by law. All information and records, including electronic records, shall be kept secure (for example, in a filing cabinet, desk, etc. under lock and key, password protected, etc.) and confidential at all times. I understand that BBBSOLA may need to exchange information with others so that the Agency can understand the needs of the child and serve to meet those needs. I hereby consent to the exchange of information, at the discretion of BBBSOLA, with my child’s mentor throughout the matching process, as well as for the purpose of match supervision throughout their mentoring relationship.Child's Name First Last I also hereby consent to any exchange of information deemed appropriate regarding my child between Big Brothers Big Sisters of London and Area and the entities listed below. 1) School/Board, Facility, Agency or Individual PhoneEmail 2) School/Board, Facility, Agency or Individual PhoneEmail 3) School/Board, Facility, Agency or Individual PhoneEmail Signature of parent/GuardianDate MM slash DD slash YYYY SMS Verification By clicking Submit, I consent to the collection of this personal information in accordance with Big Brothers Big Sisters of London and Area's Privacy and Confidentiality Policy.NameThis field is for validation purposes and should be left unchanged. Facebook Twitter Google+ LinkedIn