@php $referre_contact_details = []; $referre_contact_details[] = trim($clientdata['referre_contact_details']??''); $referre_contact_details[] = trim($clientdata['address']??''); $referre_contact_details = implode(",",array_values(array_filter($referre_contact_details))); @endphp

Part A:Informatio about you (participant):
Participant Name:	{{$clientdata['name']??''}}
Participant Date of Birth:	{{$clientdata['dob']??''}}
Contact Details (next of kin):	{{$referre_contact_details??''}}

Part B:Parent,Legal Gurdian or Representive
Surname	{{$data['parent_surname']??''}}
Given Name	{{$data['parent_givenname']??''}}
What is your relationship with the person requesting access ?	{{$data['relationship']??''}}

Contact Details
Postal Address	{{$data['postal_address']??''}}
Phone Number	{{$data['phone_number']??''}}
Email	{{$data['email']??''}}

Part C: Your information and privacy

Any personal information held by the {{$settings['app_name']??"We Care Cloud"}} is protected under the National Disability Insurance Scheme Act 2013 and the Privacy Act 1988.

@if (isset($data['aus_dept']) && $data['aus_dept'] == "Yes" ) @endif

Part D: Giving consent
Do you consent to the {{$settings['app_short_name']??"We Care Cloud"}} talking to other people about you; giving them information about you and getting information about you from:
1. The Australian Government Department of Human Services (including Centrelink and Medicare)	{{$data['aus_dept']??''}}
I consent. My CRN is	{{$data['crn']??''}}
2. State and Territory government departments	@if (isset($data['state']) && $data['state'] == "Yes") Yes, I consent @elseif (isset($data['state']) && $data['state'] == "No") No, I do not consent. I will provide the information myself. @endif
3. Your medical practitioners and health professionals	@if (isset($data['medical']) && $data['medical'] == "Yes") Yes, I consent @elseif (isset($data['medical']) && $data['medical'] == "No") No, I do not consent. I will provide the information myself. @endif
4.Your service providers	@if (isset($data['service_provider']) && $data['service_provider'] == "Yes") Yes, I consent @elseif (isset($data['service_provider']) && $data['service_provider'] == "No") No, I do not consent. I will provide the information myself. @else @endif
5. Any schools you have attended	@if (isset($data['school_attend']) && $data['school_attend'] == "Yes") Yes, I consent @elseif (isset($data['school_attend']) && $data['school_attend'] == "No") No, I do not consent. I will provide the information myself. @else @endif

@if (isset($data['agree1']) && $data['agree1'] == "Yes") @endif

Other Third Parties
If there are other people or organisations who have information about you the {{$settings['app_short_name']??"We Care Cloud"}} might need, please list them below, with an address and the details of a person to contact.
Name of Third Party	{{$data['name_of_third_party']??''}}
Details	{{$data['third_party_details']??''}}
Yes, I consent to the {{$settings['app_short_name']??"We Care Cloud"}} contacting the above parties and exchanging information about me with them

@if (isset($data['agree2']) && $data['agree2'] == "Yes" ) @endif @if (isset($data['agree3']) && $data['agree3'] == "Yes" ) @endif @if (isset($data['agree4']) && $data['agree4'] == "Yes" ) @endif

Part E: Signature
I understand I can obtain further information about how the {{$settings['app_short_name']??"We Care Cloud"}} handles my personal information from the Privacy Notice or Privacy Policy on the {{$settings['app_short_name']??"We Care Cloud"}} website.
I understand I have given the {{$settings['app_short_name']??"We Care Cloud"}} consent to ask for information about me and share my information with third parties.
Name	{{$data['name']??''}}
Signature	{{$data['signature']??''}}
Date	{{$data['date']??''}}
I understand I can withdraw my consent at any time.

@if(!empty($data['upload_file']))

Attachment

@endif