This form should be read to the beneficiary or their guardian in their mother tongue. It should be clearly explained to the beneficiary that he/she can choose any or none of the options offered.

I authorize to communicate the information relating to the incident that I declared to him as explained below:

I understand that by giving my authorization below, I allow (name of your organization) to communicate to the service provider(s) I have designated the information specifically relating to my case, contained in my incident report, in order to be able to benefit from assistance according to my security, health, psychosocial and/or legal needs.

I understand that the information communicated will be treated confidentially and with respect, and will only be disclosed if it is necessary to enable me to receive the assistance I have requested.

I understand that the disclosure of this information implies that a member of the organization or service checked below can speak to me. I have the right to change my mind at any time about the disclosure of information to the body/contact person named below.

1. Acceptance of Terms

By accessing and using the Deenal reporting system, you accept and agree to be bound by the terms and provision of this agreement.

2. Use of Service

This platform is designed to provide support and assistance to survivors of gender-based violence. You agree to use this service only for lawful purposes and in a way that does not infringe the rights of, restrict or inhibit anyone else's use of the service.

3. Confidentiality

We are committed to protecting your privacy and maintaining the confidentiality of all information you provide. All reports are handled with the utmost discretion and in accordance with applicable data protection laws.

4. Information Accuracy

You agree to provide accurate and complete information when submitting reports through this system. False reporting may result in termination of access to the service.

5. Limitation of Liability

While we strive to provide the best possible service, Deenal cannot guarantee immediate response or specific outcomes. This platform is a reporting tool and not a substitute for emergency services.

6. Changes to Terms

We reserve the right to modify these terms at any time. Continued use of the service after changes constitutes acceptance of the modified terms.