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Macmillan Welfare Rights Service - Referral Form

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Macmillan logo MACMILLAN WELFARE RIGHTS SERVICE
Central Bedfordshire Council,
Priory House, Monks Walk, Chicksands, SG17 5TQ
Referral Line: 0300 300 8145
macmillan@centralbedfordshire.gov.uk
CBC / BBC loint logo

Contact Sofie Banneel

Monday, Tuesday, Thursday 8.30am – 5.00pm

Secure Voicemail activates if line is busy or Out of Office Hours

We would like to leave a voicemail message on these numbers (See consent below)
Statement of Consent
Pathway Point - * If unsure please leave blank

Data Protection - Patient Information

Bedfordshire Macmillan Welfare Rights Service

We are asking for your consent to provide the Bedfordshire Macmillan Welfare Rights Service with this information and to allow us to record your details onto our client database. This will enable the officers of the service to contact you to offer you the service and to monitor the delivery of the service for funding and quality purposes.

The Bedfordshire Macmillan Welfare Rights Service works in partnership with Macmillan Cancer Support to deliver a welfare benefits advice service to patients with a cancer diagnosis who live in Central Bedfordshire or Bedford Borough.

By agreeing to this referral, you are consenting to the sharing of your personal information including your name, address, telephone contact number, date of birth and details of your cancer diagnosis and treatment for the purpose of enabling the Bedfordshire Macmillan Welfare Rights Service to deliver welfare benefits advice to you.

This information will be recorded onto a standard referral form and emailed by secure email to the Macmillan Welfare Rights Service or telephoned through to the Macmillan Welfare Rights Service secure referrals line. Once received the service the referral will be saved onto our system and your details will be recorded onto a client database for monitoring purposes.

In line with the General Data Protection Regulations 2018 (GDPR) your information will be retained securely for 6 years in line with Central Bedfordshire Councils data protection policy.

You may withdraw consent for the storage of this information at any time by contacting us at: Central Bedfordshire Council, Priory House, Monks Walk, Chicksands, Bedfordshire, SG17 5TQ. Telephone 0300 300 8145

I have read the Central Bedfordshire Council personal information statement and consent to the personal information I have provided on this form being used for the purposes stated.
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