Data Protection Regulations Permission Form

Name*

First Last

Email Address*

Phone Number

Do you agree to the Citizens Advice service recording information about you?

Yes
No

Do you agree to the Citizens Advice service sharing your personal information with other advice providers and/or other relevant agencies for the purposes of efficient appointments and obtaining information to help you with your issue?

Yes
No

Can we contact you for feedback? To help us understand how we’re doing and to improve our service, we may want to contact you later to ask for your feedback. Sometimes we need a trusted research organisation to help us do that. Please tick the box below if you agree to us getting in touch.*

Yes
No

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