{"id":1932,"date":"2026-01-12T14:41:00","date_gmt":"2026-01-12T20:41:00","guid":{"rendered":"https:\/\/staging5.nsd.tech\/?page_id=1932"},"modified":"2026-01-12T14:45:28","modified_gmt":"2026-01-12T20:45:28","slug":"carmis-general-consent-form","status":"publish","type":"page","link":"https:\/\/staging5.nsd.tech\/fr\/carmis-general-consent-form\/","title":{"rendered":"General Consent Form"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div class=\"x-section e1932-e1 m1ho-0\"><div class=\"x-row x-container max width e1932-e2 m1ho-1 m1ho-2\"><div class=\"x-row-inner\"><div class=\"x-col e1932-e3 m1ho-3 NsdSpacerSmallAll\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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      <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_430' id='gform_430'  action='\/fr\/wp-json\/wp\/v2\/pages\/1932' data-formid='430' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_430' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_430_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter CLIENT_UNQCODE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_430_16'>GUID<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_430_16' type='text' value='' class='large'   tabindex='1'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_430_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_430_17'>reqCode<\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_430_17' type='text' value='' class='medium'   tabindex='2'   aria-invalid=\"false\"   \/><\/div><\/div><div data-fieldId=\"17\" class=\"spacer gfield\" style=\"grid-column: span 6;\" data-groupId=\"ae57b52e\"><\/div><div id=\"field_430_18\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-third F_413 exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gpev-field\"  data-field-class=\"gpev-field\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_430_18'>userEmail<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_430_18' type='email' value='' class='large' tabindex='3'    aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_430_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third ACTOR_TYPE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_430_19'>GUTYPE<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_430_19' type='text' value='' class='medium'   tabindex='4'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_430_15\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full START_DATE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_430_15'>Submission Date (Admin Only)<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_15' id='input_430_15' type='text' value='26\/04\/2026' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='5'  placeholder='dd\/mm\/yyyy' aria-describedby=\"input_430_15_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_430_15_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_430_15' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_430_11\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>\nI hereby consent to the program administrators releasing and\/or disclosing personal information related to myself to participating service providers and partners, as outlined below.\n<\/p>\n\n<h3>PARTICIPATING PARTNERS<\/h3>\n<p>\nParticipating partners may include, but are not limited to, education providers, health services, justice and legal services, municipal services, housing and income support programs, child and family services, community-based organizations, and other relevant public or non-profit service providers involved in collaborative support planning.\n<\/p>\n\n<p>\nI am consenting to the disclosure of this information to participating partners to allow for collaborative planning and coordinated support for the purposes of:\n<\/p>\n\n<ul style=\"padding-left: 50px; list-style-type: circle;\">\n  <li>Early identification of risk factors and\/or barriers to safety, stability, and success<\/li>\n  <li>Coordination of multi-partner case planning for individuals, children, youth, and families<\/li>\n  <li>Mobilization of public and\/or private, community, and family supports<\/li>\n  <li>Navigational and referral support<\/li>\n  <li>Proactive planning to reduce crisis situations and provide crisis intervention and support<\/li>\n<\/ul>\n\n<p><strong>I am also agreeing to the following:<\/strong><\/p>\n<ul style=\"padding-left: 50px; list-style-type: circle;\">\n  <li>To participate in the program with the intention of working toward safety, stability, and success<\/li>\n  <li>To communicate respectfully with program staff if I am unable to keep appointments or if barriers arise that affect my ability to follow agreed-upon plans<\/li>\n<\/ul>\n\n<p><strong>I understand the following:<\/strong><\/p>\n<ul style=\"padding-left: 50px; list-style-type: circle;\">\n  <li>Situations involving risk of self-harm or harm to others may be reported in accordance with applicable policies and laws<\/li>\n  <li>I may withdraw my consent at any time by contacting program staff<\/li>\n  <li>Information about the program, its process, and the roles of participating partners has been explained to me<\/li>\n  <li>I authorize the sharing of personal information (including, where necessary, personal health information) among participating partners for the purposes outlined above<\/li>\n<\/ul>\n\n<p>\nThis consent is valid for 365 days from the date of signing. I understand that I may withdraw this consent in writing at any time by contacting the program administrator or designated program representative.\n<\/p>\n<\/div><div id=\"field_430_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">My information<\/h3><\/div><div id=\"field_430_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-five-twelfths FIRST_NAME gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_430_7'>My Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_430_7' 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