Informed consent

"Informed consent" means providing approval for your relevant personal information to be collected, used, disclosed and managed by the University, the police and the Australian Criminal Intelligence Commission (ACIC).

As part of the police check application process, you are presented with a statement outlining how your personal and police information will be handled. You must read this statement thoroughly and, if appropriate, indicate your agreement by ticking the box provided. If you have any queries about the statement, you can contact us.

If you do not indicate your agreement by ticking the box, you will not be able to apply for a police check through the University. Unless you obtain and provide an appropriate police check from another accredited provider, it is highly likely you will be unable to complete the placement component of your course, which could affect your ability to graduate.

A full copy of the informed consent statement is provided below for reference:

  • Statement of informed consent for police check application

    Privacy notice

    The information on this form is being collected by the University of Melbourne’s Faculty of Medicine, Dentistry and Health Sciences. You can contact us at health-hub@unimelb.edu.au.

    The information you provide will be used to request a nationally coordinated criminal history check for the purpose of administering an industry-based student placement related to your enrolled program of study at the University. Upon submitting this form, your information will be provided to the Australian Criminal Intelligence Commission (ACIC) and Australian police agencies. The ACIC and Australian police agencies use the information you provide:

    • to disclose police information relating to you, according to the purpose of the check, to the University of Melbourne;
    • to update records held about you; and
    • for law enforcement, including purposes set out in the Australian Crime Commission Act 2002 (Cth)

    Police information is disclosed by the ACIC and Australian police agencies in accordance with applicable legislation and information release policies of the Australian Government and state and territory governments. These links may help you source information on spent convictions:

    The personal and police information provided to the University through this form and the nationally coordinated criminal history check process may be processed and stored on secure third-party systems within Australia. Your personal and police information may be accessed by authorised University of Melbourne staff (including contractors) and may also be provided to your assigned student placement provider(s) so they can determine your suitability for placement. If you elect to undertake a student placement with an overseas organisation, your personal and police information may be transferred outside of Australia to the location of that overseas organisation.

    You may access any personal information you have provided to the University by contacting +61 3 9035 5511. The University of Melbourne is committed to protecting personal information provided by you in accordance with the Privacy and Data Protection Act 2014 (Vic). All information collected by the University is governed by the University’s Privacy Policy. For further information about how the University deals with personal information, please refer to the University’s Privacy Policy or contact the University’s Privacy Officer at privacy-officer@unimelb.edu.au.

    Declaration of consent

    Your informed consent is needed before the University can request and use your nationally coordinated criminal history check. Your informed consent means that you:

    1. acknowledge that you have read and understand the information provided on the Student Placements website: 
      https://mdhs.unimelb.edu.au/study/current-students/placements
    2. acknowledge that you understand the information on this form;
    3. acknowledge that the University of Melbourne is collecting information in this form to provide to the Australian Criminal Intelligence Commission (ACIC) and police agencies, for a nationally coordinated criminal history check to be conducted for the purpose of administering an industry-based student placement related to your enrolled program of study at the University;
    4. have fully and accurately completed this form, and that the personal information you have provided relates to you and contains the full name and all names previously used by you;
    5. acknowledge that withholding and/or providing misleading or false information on this form and in any identity documents provided to the University is a Commonwealth offence and may lead to prosecution under the Criminal Code Act 1995 (Cth);
    6. acknowledge that personal information that you provided in this form and on any supplied identity documents provided may be disclosed to the University (including contractors, legal entity customers, related bodies or third parties in Australia or overseas, if applicable);
    7. acknowledge that any information sent by mail or electronically in relation to this form, including identity documents, is sent at your risk and you are aware of the consequences of sending information in these ways
    8. acknowledge that you are aware that you are providing consent for a national check to be conducted on all personal information provided in this form and provided in supplied identity documents;
    9. understand and consent to police information relating to you being disclosed in accordance with the purpose identified in point 3 of this declaration, applicable legislation and information release policies (including spent convictions legislation described in Australian Government and state or territory legislation);
    10. give consent to:
      1. the ACIC and police agencies using and disclosing your personal information that you have provided in this form and personal information contained in your supplied identity documents to conduct a nationally coordinated criminal history check;
      2. the ACIC disclosing the police information sourced from the police agencies to other approved bodies and the University of Melbourne;
      3. the University collecting, using and disclosing your personal information and police information as outlined in the Privacy Notice on this form
    11. acknowledge that it is usual practice for your personal information and police information to be used by police agencies and the ACIC for law enforcement, including purposes set out in the Australian Crime Commission Act 2002 (Cth);

Australian Police Check