CONSENT TO ENHANCED DISCLOSURE (ACCESS NI) FORM THIS POST

  AUTHORIZATION AND CONSENT FOR DISCLOSURE OF CRIMINAL
APPENDIX H SURROGATE CONSENT PROCESS ADDENDUM THE
BUILDING PLATFORM CHECKLIST (VERSION NOV2019) RESOURCE CONSENT NO

CONSENTIMIENTO INFORMADO PARA LA UTILIZACIÓN DE MUESTRAS BIOLÓGICAS
ELECTROCONVULSIVE THERAPY (ECT) YOUR RIGHTS ABOUT CONSENT
INFORMED CONSENT FORM AND HIPAA AUTHORIZATION STUDY

DECLARATION OF CONVICTIONS AND CONSENT TO POC (NI) CHECK FORM



CONSENT TO ENHANCED DISCLOSURE (ACCESS NI) FORM

This post is governed by the Protection of Children and Vulnerable Adults (Northern Ireland) Order 2003. Before appointing anyone to such a post it is PlayBoard’s policy to ask for an Enhanced Disclosure, (Criminal Record Check), through Access NI. This check is to make sure those individuals who might be a risk to children and/or vulnerable adults are not appointed. A check will only be carried out if you are considered to be the preferred candidate and are being offered an appointment.

The check will tell us if your name is included on the DHSSPS Disqualification from Working with Children List or included on the DE list and/or the DHSSPS Disqualified from Working with Vulnerable Adults List. The disclosure will contain details of any spent or unspent convictions, as well as cautions, reprimands and warnings, recorded by the police centrally. It may also include certain non-conviction information from police records which a chief police officer thinks may be relevant in connection with the matter in question. It will also indicate if there are no such matters on record. Any information received will be treated confidentially in line with Access NI Code of Practice and we will talk to you about it before a final decision is reached. After the decision is made the information will be destroyed.

A criminal record will not necessarily be a bar to obtaining a position and the information will be used only to assess the suitability for employment in so far as it is relevant and applicants will be considered on merit and ability and not discriminated against unfairly.

PlayBoard complies fully with AccessNI Code of Practice and you can view this code on the Access NI web-site. www.Accessni.gov.uk

Please complete the section below asking you to give your written consent an Enhanced Disclosure. Please return this form with your application in a sealed separate envelope. If you do not consent you will not be considered for appointment.

Consent to Enhanced Disclosure



I understand that an Enhanced Disclosure must be carried out before an offer of appointment can be confirmed. This has been explained to me and I am aware that spent convictions and other non-conviction information may be disclosed. I consent to the check being made.



Signature:

Date:



Name:







Ref: POBS/O1/


PATIENT ID NUMBER PATIENT NAME INFORMED CONSENT
TERMO DE CONSENTIMENTO DE USO DE BANCO DE
(REV 10919) INFORMED CONSENT FORM (ICF) TEMPLATE INFORMED CONSENT


Tags: (access ni), (access, enhanced, consent, disclosure