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Financial Wellbeing – Referral Agency Authorisation
Financial Wellbeing Referral Agency Authorisation
Referral Agency Name
I authorise the following:
I hereby authorise you to divulge my contact details and other required personal data to any adviser/employee from the third party organisation named above in order to be able to make an effective referral.
I authorise Bridge Community Project to share special category data (e.g. health, ethnic origin, criminal record) with the above third party organisation
I authorise Bridge Community Project to keep a record of the referral made.
Client Reference Number
This begins with BR and will be assigned by your adviser
Date Format: DD slash MM slash YYYY
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