Consent to share

Organisation name, contact name, and contact details of each organisation/individual that you give us permission to share details with:

Please briefly explain what each person/organisation supports you with by name (please note that this is stored separately on our system so the named person needs to be mentioned in both sections)

Declarations

I am giving Beyond Reflections permission to share details and discuss my support with the above named organisations/people

I understand that this will be considered my digital signature for the purposes of this form

If you are a human, ignore this field