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First name

Phone number

Numeric Digits only, Please do not include symbols or your mobile country code

Email

example@example.com

Gender

Age range

Note: if you do not wish to submit your contact details, please phone IDCARE on

1800 595 160 (AU) or 0800 121 068 (NZ) during business hours (7AM - 7PM AEST)

Country of residence

State (NZ)

State (AUS)

Other

Postcode

Any requirement for relay or interpreter services?

Privacy Collection Notice

By selecting this option, you are consenting to IDCARE collecting sensitive information about yourself as outlined in the Privacy Act 1988 (Cth). This sensitive information may include health information (i.e. hearing or speech impairment) when you select the National Relay Service option. For the selection of Translating & Interpreting Services and language required, this may imply the collection of your racial or ethnic background.

Please choose the service

Please note that TIS (Translating and Interpreting Service) is only available for Australian citizens or Permanent Residents.

Please define the language

Preferred Contact Time (AEST)

In periods of high demand for our service, you may be contacted outside of this preferred time.

Preferred Method of Contact

In periods of high demand for our service, you may not be contacted via your preferred method.

Are you experiencing crimes being committed using your exposed information, such as the creation of transaction accounts, loans or other accounts being established without your authority?

Are you concerned about the compromise of any of the following (select all that apply):

Describe what has occurred:

Please be brief but detailed.0/2000

Have you been referred to IDCARE by an organisation?

What is the organisation name?

Do you have a referral code for this organisation?

Please enter the code

Only Alphabetic, Numeric and Hyphen (-) Characters are permited in this field

Privacy Collection Notice

IDCARE collects your personal information for the purpose of providing our case management services in assisting you to address any identity and cyber security related concerns. This includes information you provide in this form and/or during your interaction with IDCARE’s case managers. The collection of your personal information is in accordance with the Privacy Act 1988 (Cth).

IDCARE’s Privacy Policy explains in depth how we handle your personal information, how you can access and correct your information, and how you can make a privacy complaint. You can find this information here: IDCARE Privacy Policy.

I have read and consent to this Privacy Collection Notice

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