Common Room North Ltd. is a company registered in England and Wales.
Registered No. 12240515.
VAT Registration No. 334656393.
Consent form - MindMate Leeds podcast recording
Thank you for agreeing to take part in a podcast recording for MindMate Leeds. To take part you will need to give formal consent. We will record the podcast and upload an edited version on the MindMate podcast feed here https://mindmate.org.uk/blog/
Anonoymity / Identity
We will keep your personal information anonymous and not share your full name on the podcast or reference identifying information about you. However please note that because this is going out on a public platform and you are likely to use your first name in the recording that you may well be identifiable to listeners.
Safeguarding
Common Room takes safeguarding its participants seriously and has a safeguarding policy which all staff work to. As part of this policy, we work to the following confidentiality statement.
Common Room Confidentiality Statement
Common Room offers confidentiality to children, young people and adults we engage with through our work, including staff members. This means we will not normally share information about you to anyone outside the organisation without your agreement. We will keep information about you secure only until it is no longer needed and share this on a need-to-know basis.
There may however be times when we need to share information about you with external partners or organisations when we are concerned that you or someone else are in danger or at risk of significant harm. Wherever possible we will try to discuss this with you and gain your consent before giving out any information. However, if we are unable to do this and feel that telling you would increase the risk, we may choose to do so without your consent.
If you are unsure or would like to know more about the above, please ask one of the workers or email
liz.neill@commonroom.uk.com
Storage of personal data
These recordings will be housed on the MindMate website for an indefinite period of time. You can withdraw your consent at any time and request that the podcast is taken down from the site. You can do that by emailing Common Room (contact below).
What next?
If you have any questions about any of the above please contact liz.neill@commonroom.uk.com. We need your consent to say that you agree to take part in this activity as outlined above.
Please fill in your details below and tick the boxes below to say you give your consent to take part.
If you are under 16 years old please ensure your parent/guardian completes this [hyperlink to parent form] form also.