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Participant Consent Form

You can fill out the form online below. Alternatively, you can download the fillable PDF here (make sure to save it to your desktop first) and email it to Kathryn Woods at myhealthmycommunication@dareds.org.au, or print a copy and mail the completed form to 57 Lawson Road, Springwood, NSW, 2777,

Participant Consent Form

You can fill out the form online below. Alternatively, you can download the fillable PDF here (make sure to save it to your desktop first) and email it to Kathryn Woods at myhealthmycommunication@dareds.org.au, or print a copy and mail the completed form to 57 Lawson Road, Springwood, NSW, 2777,

Participant Sign Up Form

You can fill out the form online below. Alternatively, you can download the fillable PDF here. (make sure to save it to your desktop first) and email it to Kathryn Woods at myhealthmycommunication@dareds.org.au, or print a copy and mail the completed form to 57 Lawson Road, Springwood, NSW, 2777,

DARE Disability Support and Nepean Blue Mountains Local Health District are working together to discover what good communication in hospital looks like for people with communication disabilities, in particular, people with intellectual and developmental disabilities.

This can be about:

  • The way that healthcare workers talked to you about things,
  • How you felt when talking to healthcare workers, and
  • How important information about you was shared between health staff and your support people.

We would like you to tell us about your thoughts and share your ideas with us so we can make communication better.

By filling in the consent form below, you’re let us know that you’re happy for us to use your thoughts in our research.

Person with Disability Smiling

DARE Disability Support and Nepean Blue Mountains Local Health District are working together to discover what good communication in hospital looks like for people with communication disabilities, in particular, people with intellectual and developmental disabilities.

This can be about:

  • The way that healthcare workers talked to you about things,
  • How you felt when talking to healthcare workers, and
  • How important information about you was shared between health staff and your support people.

We would like you to tell us about your thoughts and share your ideas with us so we can make communication better.

By filling in the consent form below, you’re let us know that you’re happy for us to use your thoughts in our research.

Person with Disability Smiling

DARE Disability Support and Nepean Blue Mountains Local Health District are working together to discover what good communication in hospital looks like for people with communication disabilities, in particular, people with intellectual and developmental disabilities.

This can be about:

  • The way that healthcare workers talked to you about things,
  • How you felt when talking to healthcare workers, and
  • How important information about you was shared between health staff and your support people.

We would like you to tell us about your thoughts and share your ideas with us so we can make communication better.

By filling in the form below, you’re letting us know how you want to get involved in our project and how you want to share information.

Part of the project involves filling in a survey, which you will automatically be taken to upon filling in the form below. You are welcome to provide an anonymous response to the survey, your survey response will not be linked to your sign up form submission. By filling in the survey you are agreeing to let us use your response in all project activities.

Person with Disability Smiling

Consent Form

Please fill in the form below, you can ask a support person to assist you.

If you have any issues filling in the form please contact Kathryn Woods at myhealthmycommunication@dareds.com.au.

You can change your mind at any time, we will never ask you to do or say anything that you are not okay with.

Consent Form

Please fill in the form below, you can ask a support person to assist you.

If you have any issues filling in the form please contact Kathryn Woods at myhealthmycommunication@dareds.com.au.

You can change your mind at any time, we will never ask you to do or say anything that you are not okay with.

Sign Up Form

Please fill in the form below, you can ask a support person to assist you.

If you have any issues filling in the form please contact Kathryn Woods at myhealthmycommunication@dareds.com.au.

You can change your mind at any time, we will never ask you to do or say anything that you are not okay with.

    I give my consent for my survey response to be used by the My Health My Communication project.

    Once you have completed the survey that will appear after you submit this form, Kathryn Woods, the project manager, would like to find a time talk to you about the last time you went to hospital. Would you like to talk to Kathryn about the last time you went to hospital?

    Kathryn can talk to you over the phone, through emails, or she can talk to you in person. How would you like to talk to Kathryn?

    Are you okay with having a video or your voice recorded when we talk?

    Can we share the things you say to us in your videos, and voice recordings to train healthcare workers in hospitals and disability workers?



    Your name, address and contact details will not be given to anyone and will be always be kept safe by DARE.

      I give my consent for my survey response to be used by the My Health My Communication project.

      Once you have completed the survey that will appear after you submit this form, Kathryn Woods, the project manager, would like to find a time talk to you about the last time you went to hospital. Would you like to talk to Kathryn about the last time you went to hospital?

      Kathryn can talk to you over the phone, through emails, or she can talk to you in person. How would you like to talk to Kathryn?

      Are you okay with having a video or your voice recorded when we talk?

      Can we share the things you say to us in your videos, and voice recordings to train healthcare workers in hospitals and disability workers?



      Your name, address and contact details will not be given to anyone and will be always be kept safe by DARE.

        I give my consent for my survey response to be used by the My Health My Communication project.

        Once you have completed the survey that will appear after you submit this form, Kathryn Woods, the project manager, would like to find a time talk to you about the last time you went to hospital. Would you like to talk to Kathryn about the last time you went to hospital?

        Kathryn can talk to you over the phone, through emails, or she can talk to you in person. How would you like to talk to Kathryn?

        Are you okay with having a video or your voice recorded when we talk?

        Can we share the things you say to us in your videos, and voice recordings to train healthcare workers in hospitals and disability workers?



        Your name, address and contact details will not be given to anyone and will be always be kept safe by DARE.