Consent Form to Hold and Release Student Information

All students undertaking Work Integrated Learning at Federation University are required to download, complete, sign and upload the Hold and Release Student Information Consent Form to their student profile page on InPlace.

The information on this consent form is collected for the primary purpose of gaining your consent to hold and release your personal information for the duration of your enrolment with Federation University Australia. This information will include the following:

  • your personal details may be forwarded to clinical and/or work integrated learning settings (e.g. Hospitals, Schools, community centres, etc.) as required prior to you undertaking clinical and/or work integrated learning placements;
  • your personal details will be uploaded to Federation University’s InPlace student placement system and other placement agency’s placement systems such as VicPlace, the Department of Health system for Clinical Placement requests as required prior to you undertaking clinical and/or work integrated learning placements;
  • your personal details and academic results to The Australian Health Practitioner Regulation Agency (AHPRA) as may be required by them for student and nurse registration or to the Victorian Institute of Teaching (VIT) for education students.
  • Information regarding the outcomes of the following checks:

Police check

Working with Children Check

Immunisation status

Medical information

In order to provide the above information, and in accordance with the requirements of Victorian privacy laws, Federation University Australia requires your consent to hold and disclose this information as described above.

Should you elect not to provide consent for the above this may result in your clinical and/or work integrated learning placements being cancelled, delayed or limited and therefore delay your progress through your program and/or Registration with external accreditation agencies such as AHPRA or VIT.

Please download the Hold and Release Student Information Consent Form (PDF, 49.76kb).

Students must sign and upload a scanned copy of this form to your personal profile in InPlace.

This form will be retained by Federation University.