ࡱ > } | ` jbjb r |c |c # V V V 8 L | p: C) 1+ $ U, c9 e9 e9 e9 e9 e9 e9 , T< R > 9 V , o& C) , , 9 , *: , , , , l V c9 , j ~ , c9 , , r 7 T * , V 8 , c7 8 T @: 0 p: q7 V? , V? 8 , V 0 d 0 P r o f i l e : L i v i n g a n d C a r i n g A r r a n g e m e n t s
T o a s s i s t w o r k e r s / p r a c t i t i o n e r s t o s c r e e n f o r c o n s u m e r s a c c o m m o d a t i o n a n d f i n a n c i a l n e e d s . C o n s u m e r
N a m e : F O R M T E X T
D a t e o f B i r t h : d d / m m / y y y y F O R M T E X T / F O R M T E X T / F O R M T E X T
S e x : F O R M T E X T
U R N u m b e r : F O R M T E X T
o r a f f i x l a b e l h e r e
L i v i n g A r r a n g e m e n t s C o d e : F O R M T E X T
C o m m e n t o n l i v i n g a r r a n g e m e n t s , i n c l . f a m i l y a r r a n g e m e n t s a n d c a r e r r e s p o n s i b i l i t i e s : F O R M T E X T
A c c o m m o d a t i o n C o d e : F O R M T E X T
C o m m e n t s : F O R M T E X T
E m p l o y m e n t S t a t u s C o d e : F O R M T E X T
C o m m e n t s : F O R M T E X T
F i n a n c i a l a n d L e g a l P r o f i l e
M e n t a l H e a l t h A c t S t a t u s : F O R M T E X T C o d e : F O R M T E X T
W h a t i s t h e c o n s u m e r s M e n t a l H e a l t h A c t s t a t u s ?
O t h e r L e g a l O r d e r
I s t h e c o n s u m e r s u b j e c t t o a n y o t h e r l e g a l o r d e r ? I f y e s s p e c i f y :
F O R M T E X T
D e c i s i o n M a k i n g R e s p o n s i b i l i t y C o d e :
Q 1 I s t h e c o n s u m e r m a k i n g t h e i r o w n d e c i s i o n s ? F O R M T E X T
Q 2 W h o m a k e s t h e c o n s u m e r s l e g a l d e c i s i o n s ? F O R M T E X T
Q 3 W h o m a k e s t h e c o n s u m e r s f i n a n c i a l d e c i s i o n s ? F O R M T E X T
Q 4 D o y o u h a v e a c o n c e r n t h a t t h e c o n s u m e r i s n o t F O R M T E X T c a p a b l e o f m a k i n g t h e i r o w n d e c i s i o n s ?
( I f y e s t o Q 4 , c o n s i d e r t h e n e e d f o r a s s i s t a n c e , t h e n e e d f o r c o g n i t i v e a s s e s s m e n t a n d t h e i m p l i c a t i o n s f o r c o n s e n t . ) F i n a n c i a l S i t u a t i o n F O R M T E X T C o d e : F O R M T E X T
I n t h e l a s t m o n t h , h a v e y o u h a d s u f f i c i e n t m o n e y t o p a y f o r a l l y o u r p r e s c r i b e d m e d i c a t i o n s , n e c e s s a r y m e d i c a l c a r e , a c c o m m o d a t i o n , a d e q u a t e f o o d a n d h o m e c a r e ?
( I f n o d i s c u s s i s s u e s w i t h c o n s u m e r a n d c o n s i d e r n e e d f o r c o u n s e l l i n g ( e . g . f i n a n c i a l , g a m b l i n g ) a n d n e e d f o r m a t e r i a l o r o t h e r s u p p o r t . )
C o n s u m e r s C a r e r I n f o r m a t i o n
C a r e r A v a i l a b i l i t y ( F O R M T E X T C o d e : F O R M T E X T
C a r e r R e s i d e n c y S t a t u s F O R M T E X T C o d e : F O R M T E X T
R e l a t i o n s h i p o f C a r e r t o C a r e R e c i p i e n t
F O R M T E X T C o d e : F O R M T E X T
C a r e r A l l o w a n c e / C a r e r P a y m e n t F O R M T E X T C o d e : F O R M T E X T
I f c u r r e n t l y n o t i n r e c e i p t o f c a r e r s a l l o w a n c e o r p a y m e n t , c o n s i d e r e x p l o r i n g e l i g i b i l i t y .
S u s t a i n a b i l i t y o f C a r e r A r r a n g e m e n t s
F O R M T E X T C o d e : F O R M T E X T
A r e c u r r e n t c a r e r a r r a n g e m e n t s s u s t a i n a b l e w i t h o u t a d d i t i o n a l s e r v i c e s o r s u p p o r t ?
T h r e a t s t o C a r e r A r r a n g e m e n t F O R M T E X T C o d e : F O R M T E X T
A r e t h e r e c u r r e n t t h r e a t s t o t h e c a r e r a r r a n g e m e n t ?
I f y e s t o e i t h e r o f t h e a b o v e q u e s t i o n s p r o v i d e m o r e d e t a i l i n t h e c o m m e n t s b o x b e l o w .
C o m m e n t o n a n y c a r e r i s s u e s t h a t m a y i m p a c t o n c o n s u m e r s c a r e : F O R M T E X T
O t h e r r e l e v a n t i n f o r m a t i o n : F O R M T E X T
R e f e r r a l R e c o m m e n d e d T o : F O R M T E X T
P r o d u c e d b y t h e V i c t o r i a n D e p a r t m e n t o f H u m a n S e r v i c e s , 2 0 0 6 T h i s i n f o r m a t i o n c o l l e c t e d b y : L C A P a g e 1 o f 1 N a m e : F O R M T E X T P o s i t i o n / A g e n c y : F O R M T E X T S i g n : D a t e : d d / m m / y y y y F O R M T E X T / F O R M T E X T / F O R M T E X T C o n t a c t n u m b e r : F O R M T E X T
L i v i n g a n d C a r i n g A r r a n g e m e n t s
* , @ B P n p
. F H \ ^ l uj h`R CJ Uj h`R CJ U
h`R CJ h`R 5B*CJ ph j h`R B*CJ Uph j> h`R Uj h`R Uj` h`R Uj h`R Ujt h`R U h`R 5j h`R Uj h`R Uh`R . P
R 0 n - $ $If a$l - $If l , $If l $If l $If l $If l Z \ V T = (
$If l B K$
$If l kd $$If l nF d' d &
t
0 ' 2
l 2 q 4 l 4 n4 al p
,
.
B
D
F
P
R
V
X
~
ȾȱzȾm j h`R CJ U#j h`R B*UmH nH ph u j h`R B*Uph j h`R B*Uph h`R B*ph j! h`R CJ Uj h`R CJ U
h`R CJ h`R 5B*CJ ph j h`R UmH nH u j% h`R Uh`R j h`R U $
T
m
$If l K$
d $If l c kd $If K$L$l n 0 6 4
l 4 a T
V
m
$If l K$
d $If l c kd $If K$L$l 7 0 6 4
l 4 a
$ & H X Z \ p r t ~ 6 ͵͔ņzoņe]]] h`R B*ph h`R 5B*ph jw h`R Uh`R 5B*CJ ph j h`R UmH nH u j h`R Uh`R B*CJ ph h`R 6B*CJ ph j h`R 6B*CJ Uph j h`R Uh`R #j h`R B*UmH nH ph uj h`R B*Uph j h`R B*Uph
$ 6 n ^ J ^ x $If l $If l
$If l
d $If l c kd{ $If K$L$l 7 0 6 4
l 4 a "
$
.
0
2
$ & ( , . 0 2 2 ɿɇɗwɗg jK
h`R B*Uph j h`R B*Uph ja h`R B*Uph j h`R Uh`R 5B*CJ ph h`R 5B*ph h`R B*CJ ph j h`R CJ Uh`R B*ph #j h`R B*UmH nH ph uj h`R B*Uph j h`R B*Uph ' 0
0 ~ D X l \ $If l
F $If l $If l
Tx $If ^T`l
T $If ^T`l
x $If l $&d If P l
2 4 6 : < ~ B D X Z ĺ~tet[U
h`R CJ j h`R CJ U j h`R B*CJ Uph h`R 6B*ph j h`R Uh`R 5B*CJ ph j h`R UmH nH u j7 h`R Uj h`R Uh`R h`R B*CJ ph h`R 6h`R B*ph #j h`R B*UmH nH ph uj h`R B*Uph j
h`R B*Uph !X F : v $If l
F ( $If l
F $If l
F d $If l
F d P $If l $If l
B D F Z \ ^ h j l v x z ƺƲƧƲƺƲtƊi j
h`R Uj
h`R Uj
h`R U j h`R B*CJ Uph j h`R UmH nH u j h`R Uj h`R Uh`R 5B*CJ ph h`R j h`R CJ UmH nH u j# h`R CJ U
h`R CJ j h`R CJ U j h`R CJ )
" $ & : < > B D F J
. 0 2 6 8 : < ȹȹ jI h`R Uj h`R Uj] h`R Uj h`R U j h`R B*CJ Uph
h`R CJ jq h`R Uh`R 5B*CJ ph h`R j h`R UmH nH u j h`R U 7 " 6 8 : D F H R T V j l n r t v $ & ( 2 4 v x ~ h`R 5CJ OJ QJ mH sH j h`R Uj h`R Uj h`R U h`R 6j5 h`R Uh`R 5B*CJ ph j h`R UmH nH u j h`R Uj h`R Uh`R
h`R CJ j h`R CJ U , 6 8 : y i $If l c kd! $If K$L$l 0 6 4
l 4 a $If l B K$ d $If l : < > K ] kd $$If l 4 ' ' 0 '6 4 l al $If l E kd $$If 0 ' '6 2 a ~ s c $ $If l $
r U" $If a$l
9r $If l ] kd $$If l ' ' 0 '6 4 l al ~ 6 8 L N \ ^ ` j l . 0 D F T V X ݸհv h`R CJ OJ QJ mH sH j$ h`R Uj h`R UjD h`R Uj h`R Uh`R OJ QJ
h`R 5CJ jP h`R Uj h`R Uj h`R Uh`R 5OJ QJ
h`R 0J h`R h`R 5CJ OJ QJ mH sH .~ { k [ % $If l # $If l kd
$$If l F ' 0 '6 4
l al ^ o _ _ " $If l kd $$If l 0 ' 0 '6 2 4
l al p ^ ` l V k [ [ [ " $If l kd $$If l 0 ' 0 '6 2 2 U 4
l al p V X Z \ ^ ` M K I I I G I I & kd $$If l F '
0 '6 2 2 U 4
l al p ( {. A!n"p#$ % X" ,,
g{ H H ( d h
com.apple.print.PageFormat.FormattingPrinter
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.FormattingPrinter
Acrobat_Distiller_Tancredi_on_localhost
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T22:33:29Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PageFormat.PMHorizontalRes
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMHorizontalRes
300
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T08:50:57Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PageFormat.PMOrientation
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMOrientation
1
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T22:33:29Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PageFormat.PMScaling
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMScaling
1
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T22:33:29Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PageFormat.PMVerticalRes
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMVerticalRes
300
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T08:50:57Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PageFormat.PMVerticalScaling
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMVerticalScaling
1
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T22:33:29Z
com.apple.print.ticket.stateFlag
0
com.apple.print.subTicket.paper_info_ticket
com.apple.print.PageFormat.PMAdjustedPageRect
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMAdjustedPageRect
0.0
0.0
3508.3333333333335
2479.166666666667
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T22:33:29Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PageFormat.PMAdjustedPaperRect
com.apple.print.ticket.creator
com.apple.printingmanager
com.apple.print.ticket.itemArray
com.apple.print.PageFormat.PMAdjustedPaperRect
0.0
0.0
3508.3333333333335
2479.166666666667
com.apple.print.ticket.client
com.apple.printingmanager
com.apple.print.ticket.modDate
2005-10-26T22:33:29Z
com.apple.print.ticket.stateFlag
0
com.apple.print.PaperInfo.PMConstrainedPaper
com.apple.print.ticket.creator
CUPS_CPL
com.apple.print.ticket.itemArray
com.apple.print.PaperInfo.PMConstrainedPaper
com.apple.print.ticket.client
CUPS_CPL
com.apple.print.ticket.modDate
2005-10-26T22:33:28Z
com.apple.print.ticket.stateFlag
1
com.apple.print.PaperInfo.PMPaperName
com.apple.print.ticket.creator
CUPS_CPL
com.apple.print.ticket.itemArray
com.apple.print.PaperInfo.PMPaperName
iso-a4
com.apple.print.ticket.client
CUPS_CPL
com.apple.print.ticket.modDate
2005-10-26T22:33:28Z
com.apple.print.ticket.stateFlag
1
com.apple.print.PaperInfo.PMUnadjustedPageRect
com.apple.print.ticket.creator
CUPS_CPL
com.apple.print.ticket.itemArray
com.apple.print.PaperInfo.PMUnadjustedPageRect
0.0
0.0
842
595
com.apple.print.ticket.client
CUPS_CPL
com.apple.print.ticket.modDate
2005-10-26T22:33:28Z
com.apple.print.ticket.stateFlag
1
com.apple.print.PaperInfo.PMUnadjustedPaperRect
com.apple.print.ticket.creator
CUPS_CPL
com.apple.print.ticket.itemArray
com.apple.print.PaperInfo.PMUnadjustedPaperRect
0.0
0.0
842
595
com.apple.print.ticket.client
CUPS_CPL
com.apple.print.ticket.modDate
2005-10-26T22:33:28Z
com.apple.print.ticket.stateFlag
1
com.apple.print.PaperInfo.ppd.PMPaperName
com.apple.print.ticket.creator
CUPS_CPL
com.apple.print.ticket.itemArray
com.apple.print.PaperInfo.ppd.PMPaperName
A4
com.apple.print.ticket.client
CUPS_CPL
com.apple.print.ticket.modDate
2005-10-26T22:33:28Z
com.apple.print.ticket.stateFlag
1
com.apple.print.ticket.APIVersion
00.20
com.apple.print.ticket.privateLock
com.apple.print.ticket.type
com.apple.print.PaperInfoTicket
com.apple.print.ticket.APIVersion
00.20
com.apple.print.ticket.privateLock
com.apple.print.ticket.type
com.apple.print.PageFormatTicket
t D T e x t 1 v D T e x t 6 4 v D T e x t 6 4 j D t D T e x t 3 t D T e x t 4 $$If l !v h5 d5 5%#v%#v #v d:V l n
t
0 '5&5 5 d/ / 2
l 2 q 4 nal p
t D T e x t 5 v D T e x t 2 0 $If K$L$q !v h5 #v :V l n0 6 5 4 t D T e x t 6 v D T e x t 2 1 $If K$L$q !v h5 #v :V l 70 6 5 4 t D T e x t 7 v D T e x t 2 2 $If K$L$q !v h5 #v :V l 70 6 5 4 v D T e x t 2 3 t D T e x t 8 v D T e x t 2 4 t D T e x t 9 v D T e x t 1 0 v D T e x t 1 1 v D T e x t 1 2 v D T e x t 3 2 v D T e x t 1 3 v D T e x t 3 3 v D T e x t 1 4 v D T e x t 3 4 v D T e x t 1 5 v D T e x t 3 5 v D T e x t 1 6 v D T e x t 3 6 v D T e x t 1 7 v D T e x t 3 7 v D T e x t 1 8 v D T e x t 3 8 v D T e x t 1 9 v D T e x t 3 1 $If K$L$q !v h5 #v :V l 0 6 5 4 e $$If !v h5 5#v#v :V '6 55 2 4 v D T e x t 2 5 $$If l !v h5 '#v ':V l 40 '6 5 '4 l al v D T e x t 2 6 $$If l !v h5 '#v ':V l 0 '6 5 '4 l al $$If l !v h5 55#v#v#v :V l 0 '6 , 555 / / 4 al $$If l !v h5 5 #v #v :V l 0 '6 5 5 / / 2 4 al p v D T e x t 2 7 v D T e x t 2 8 $$If l !v h5 5#v#v :V l 0 '6 , 55 / / 2 2 U 4 al p v D T e x t 6 4 v D T e x t 6 4 j D v D T e x t 3 0 2$$If l !v h5 5
5 #v #v
#v :V l 0 '6 , 5 5
5 /
/ 2 2 U 4 al p . < @ < N o r m a l OJ QJ mH sH tH L L H e a d i n g 1 $@& 5B*CJ< OJ QJ ph D A@ D D e f a u l t P a r a g r a p h F o n t Z i@ Z T a b l e N o r m a l :V 4
l 4 a _H ( k@ ( N o L i s t \ O \ A H e a d i n g A d CJ, OJ QJ mH nH sH tH u J J
D H S T e x t 1 0 p t 1$ 5$ 7$ 8$ 9D H$ N N
D H S T e x t 1 2 p t 1$ 5$ 7$ 8$ 9D H$ CJ T O"T A M a i n S u b h e a d OJ QJ mH nH sH tH u B B D H S R e p o r t H d 2 5CJ f Bf A C o n s u m e r H e a d d, < " 5CJ OJ QJ mH nH sH tH u` R` A C o n s u m e r t e x t d < OJ QJ mH nH sH tH u < b< t a b l e B*CJ OJ QJ ph b " b C a p t i o n dT d 7$ 8$ H$ B*CJ OJ QJ mH ph sH u ` O` A H e a d i n g B dT d CJ OJ QJ mH nH sH tH u ^ O^ A B o d y t e x t d < 7$ 8$ H$ CJ OJ QJ mH sH tH > P > B o d y T e x t 2 6OJ QJ l l A T a b l e h e a d i n g d 7$ 8$ H$ ! B*CJ OJ QJ mH ph sH tH F @ F F o o t e r 1$ 5$ 7$ 8$ 9D H$
9r . )@ . P a g e N u m b e r 4 4 H e a d e r
! n n A s m a l l c a p t i o n d x
" 6CJ OJ QJ mH nH sH tH uB OB A B o d y s m a l l d CJ R R A B o d y s m a l l i n d e n t ! ^ ` H O1"H
A F o o t e r l e f t "
U" 5 h O2h A F o o t e r b o l d l e f t # d8 " 5CJ OJ QJ mH nH sH tH uH O1BH A F o o t e r b o l d r i g h t $ $a$ > O!R> A F o o t e r r i g h t % $a$ \ Ob\ A s i d e t i t l e & $a$" 5CJ OJ QJ mH nH sH tH uH rH A B o d y 5 m m t a b ' ^ ` L L C o m m e n t T e x t ( 1$ 5$ 7$ 8$ 9D H$ CJ X X A B o d y b u l l e t 1 )
& F
^ ` ` ` D H S H D H e a d i n g * ' 5B* CJ& KH mH nH ph sH tH u R Q R B o d y T e x t 3 + 6B*OJ QJ mH ph sH u f O f A C o n s u m e r h e a d s m a l l , d 5OJ QJ mH nH uh O h A C o n s u m e r t e x t s m a l l - d CJ OJ QJ mH nH u " ) " % P *P "& ( 7 K L N z * + V t u ^ r [ ? ~ " M v K q ; p
O
P
Q
~
/ 0 6 0 ˀ 0 ˠ 0 ˠ ,0 ˀ -0 Й -0 Й -0 Й -0 Й -0 ˠ 0 ˠ 0 0 Й 0 Й 0 0 Й 0 Й 0 0 Й 0 Й 0 0 0 Й 0 0 0 0 Й 0 0 Й 0 Й 0 Й 0 Й 0 0 Й 0 0 0 0 Й 0 Й 0 0 Й 0 Й 0 0 0 Й 0 0 Й 0 0 0 Й 0 0 0 0 0 Й 0 0 0 Й 0 0 0 0 $0 0 #0 %0 0 "0 Й "0 Й 0 "0 "0 Й "0 Й 0 0 &0 0 @ K L (N" tx/:ptwww/ppa.c.elD/mo
@
2 " T
X : ~ ^ V ! # $ % & ' # / 5 i u x
" ( E Q T ` l r ^ j p J V Y S _ e m y | " . 4 < H K x r ~ " * 6 9
;
G
M
j
v
|
' - I U X ` l o t FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF 8 2 3 @ 2 , (
v
C F . ` `T V `T V v
C F . ` `T V `T V v
C F . ` `T V `T V v
C F . ` `T V `T V v
C F . ` `T V `T V $ v
C F . ` `T V `T V v
C F . ` `T V `T V v
!
C F . ` `T V `T V
v
#
C F . ` `T V `T V v
$
C F . ` `T V `T V v
%
C F . ` `T V `T V v
&
C F . ` `T V `T V v
'
C F . ` `T V `T V v
(
C F . ` `T V `T V r
)
6 )
v
*
C F . ` `T V `T V \ B
+
S D " \ B
,
S D " \ B
-
S D "
\ B
.
S D " \ B
/
S D " \ B
0
S D "
\ B
1
S D " \ B
2
S D " B
S ? L N + u r ~
v w K q ) A x$ = t * _% & 5 t D V k } t D k t D k t D k t + t D k t D > k e t D M k t t ! D 9 k ` t , t # j t - j ! ! t . : ! ! t $ . t / ! x ! t % 8 t 0 ! T ! t & B t ' 3 Z t 1 ! x ! t ( t 2 ! ! t $ T e x t 1 T e x t 3 T e x t 4 T e x t 5 T e x t 2 0 T e x t 6 T e x t 2 1 T e x t 7 T e x t 2 2 T e x t 2 3 T e x t 8 T e x t 2 4 T e x t 9 T e x t 1 0 T e x t 1 1 T e x t 1 2 T e x t 3 2 T e x t 1 3 T e x t 3 3 T e x t 1 4 T e x t 3 4 T e x t 1 5 T e x t 3 5 T e x t 1 6 T e x t 3 6 T e x t 1 7 T e x t 3 7 T e x t 1 8 T e x t 3 8 T e x t 1 9 T e x t 3 1 T e x t 2 5 T e x t 2 6 T e x t 2 7 T e x t 2 8 T e x t 3 0 $ j F a _ K T n # = y s +
<
k
! " # 6 y ) U s q Z f } 5 L # :
N
}
. IC@y v= SQl$) zT\ h ^`OJ QJ o( h ^`OJ QJ o( o h p p^p`OJ QJ o( h @ @ ^@ `OJ QJ o( h ^`OJ QJ o( o h ^`OJ QJ o( h ^`OJ QJ o( h ^`OJ QJ o( o h P P^P`OJ QJ o( h ^`OJ QJ ^J o( h ^`OJ QJ ^J o( o h p p^p`OJ QJ ^J o( h @ @ ^@ `OJ QJ ^J o( h ^`OJ QJ ^J o( o h ^`OJ QJ ^J o( h ^`OJ QJ ^J o( h ^`OJ QJ ^J o( o h P P^P`OJ QJ ^J o( h ^`OJ QJ o( h ^`OJ QJ o( o h p p^p`OJ QJ o( h @ @ ^@ `OJ QJ o( h ^`OJ QJ o( o h ^`OJ QJ o( h ^`OJ QJ o( h ^`OJ QJ o( o h P P^P`OJ QJ o( h ^`OJ QJ ^J o( h ^`OJ QJ ^J o( o h p p^p`OJ QJ ^J o( h @ @ ^@ `OJ QJ ^J o( h ^`OJ QJ ^J o( o h ^`OJ QJ ^J o( h ^`OJ QJ ^J o( h ^`OJ QJ ^J o( o h P P^P`OJ QJ ^J o( z v= IC SQ @38 K L N z * + V t u ?
O
P
Q
~
/ 0 6 " 6 " " @
p+ +
U n k n o w n G T i m e s N e w R o m a n 5 mstr ` S y m b o l 3 A r i a l A A r i a l N a r r o w 7 V e r d a n a ?1M C o u r i e r N e w ; W i n g d i n g s 7 C o u r i e r 1 h '&Efܚ ! 4 d T ` `R % C o n s u m e r C o n s e n t t o S h a r e I n f o r m a t i o n R o b e r t D i R e n z o R o b e r t D i R e n z o
Oh +'0 $ < H
d p |
' & Consumer Consent to Share Information . Robert Di Renzo Living and Caring LO 6A.dot Robert Di Renzo 3 Microsoft Word 11.1 @ @ 0@ ! JRR==VV9RF1JRVV==9)JF1B5F19JRcs N sVg9sVg9sRcVcg9NskZVVZRZkZg9kZ kZ s s O scZZ^BRcsF1sF1^ZNs^VJRZ^^NsJRccsZ^g9s F s^Z^BJR^NsRRZNsNs^Z^ZNsZRRc^VJRVs s s $ s ZRZ^ZZ^c s s ' s cVZg9VZR^^R s 5 sww{kZ{w{{{{s{ q ZF1=F1RR1NsF1F1JRg9F1NscJRwwo{ kZ^Vc^Ro{wcVVcwwss ' kZ kZ 8 VV^Vco{ZccVZcg9^ cg9 ccZZNso{ccZVcckZccNsZ^cZg9cg9RZkZg9 RkZVZc^VkZ^VR^ZZ^ZkZcNsc^cR^ccJRZJRkZckZ } cVccJRNsZccZkZV^kZ^cF1^RZ VkZZckZkZcZZcJRVc^Z^cNsVRcZccZ^cZRckZR U #VkZg9g9o{kZo{^o{kZ^Vo{kZo{o{kZc^g9^kZZ^g9kZkZRso{kZo{o{kZg9kZ I ^kZ^o{g9co{cZcg9o{^kZkZ^cco{cg9ccg9kZg9kZ s = kZw{{skZw{
o{g9{{{o{{{ a kZ{ {{o{{sw{^sNsNsJRg9F1cJR^sB5c==cJRg9BRNsNs 8 RF1RNsJRg9JRg9NsBBc=Nswwo{ : sVRo{wg9VwVwcwwss # ccZZNso{Z = sVRo{kZZZwZc^g9sVcZwwss 4 kZZRVcZwZZwsVo{Zo{Zs 1 g9{{{s{{{sg9o{{o{{ > JRwJRg9F1=VJRg9F1NscVRB5JRwwo{ - ws wwss , ccZZNso{Z wss H ZkZRRcRcco{VRkZ^VZg9kZV^VcVcc G cVcNsNskZkZccR^kZRcVkZcNskZVRkZZw C g9w{ww{{o{s{{wg9wwkZs } Z=BNsR5kZBNsBZF1F1BkZZ{9g9-kscZV^VwcZwsVo{Zo{wNsc^ZZRcZ kZ N wV^VwVVww^sVcZwwo{ wwss F NsVcNsV^kZcc^ZNscJR^cZkZ^ ? c^c^Z RccV^ZkZ^cV^c R 1
swRwZ^Vo{o{Zo{ G kZwRVZZsVRo{wo{Nsc^ZZRcwwss W VV^kZccNsZ^kZc^F1kZZcRcV^kZRccVR^kZ D ^RV^RkZ^kZ^Zo{R^ZNsV^kZcRkZ ' Zg9^cc^kZg9s _ +^kZZkZg9kZc^kZo{kZkZskZkZo{co{^c^cckZRkZg9sg9g9kZo{kZccZo{ ! kZkZo{kZ^s o{Z^VVcwRw^^kZZZJRcZwwg9 wwssccZZNso{cg9kZcRkZVNs^JRcRRkZZcVZc ' kZcNsZ^g9VVV M ZkZVV^kZcc^Z^Rc^VcV^kZcZRVVcckZ M Zg9Nss^cZNs^cV^kZcc^Z^RRcckZJRkZVVcV P Zg9Nss^cZNs^cV^kZcc^Z^RZc VR^kZVVcV R ZkZRcR^^cRckZcNsVVcV^kZccNsZ^kZVcco{ ; kZccNsRcg9Zc^VcV^kZcJRkZVVcV U #VkZo{cZkZo{kZo{o{^Zco{kZkZRg9o{o{g9g9o{^kZo{kZg9^g9kZkZo{skZ D o{kZo{o{ckZo{g9o{g9g9kZZkZg9o{co{o{^g9kZo{o{kZo{s 1 ZV^kZ^RRco{VRRc^ccs 1 R^RkZVR^kZcZJRcZJRccs K g9^kZg9o{VkZZkZo{^o{g9^kZco{RkZg9^ZNsZkZo{o{kZZ^c A ss^JRZNsg9R^ZRg9ZcZcsg9Z^^g9ZV^ s s s D s^ZcsZg9ZcNsVVg9s Zcc^R^V^c^s s
՜. +,0 h p
' Aria Design & Consumer Consent to Share Information Title
! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 ; < = > ? @ A B C D E F G I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g i j k l m n o p q r s u v w x y z { ~ R o o t E n t r y F SN D a t a
: 1 T a b l e H r? W o r d D o c u m e n t r S u m m a r y I n f o r m a t i o n ( h $ D o c u m e n t S u m m a r y I n f o r m a t i o n 8 t C o m p O b j X F Microsoft Word Document NB6W Word.Document.8