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CA Santa Clara County HMIS Client Consent to Data Collection and Release of Information 2015 free printable template

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CLIENT CONSENT TO DATA COLLECTION AND ROI Page 1 of 5 SANTA CLARA COUNTY HIS CLIENT CONSENT TO DATA COLLECTION AND RELEASE OF INFORMATION THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED
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How to fill out CA Santa Clara County HMIS Client Consent

01
Obtain the CA Santa Clara County HMIS Client Consent form.
02
Begin by filling out the client's personal information, including name, date of birth, and contact information.
03
Indicate the purpose of consent, such as for data sharing among service providers.
04
Read through the terms of consent carefully, ensuring clarity on how the information will be used.
05
If applicable, mark any specific services or information that the client may not want to share.
06
Have the client sign and date the consent form to indicate their understanding and agreement.
07
Provide a copy of the signed consent form to the client for their records.

Who needs CA Santa Clara County HMIS Client Consent?

01
Individuals seeking services from organizations that participate in the Santa Clara County Homeless Management Information System (HMIS).
02
Service providers who need consent to collect and share client data within the HMIS framework.
03
Clients who wish to access assistance and require their data to be shared for effective service delivery.
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CA Santa Clara County HMIS Client Consent is a document that allows clients to authorize the sharing of their personal information within the Homeless Management Information System (HMIS) to provide better services and support.
Any client receiving services from organizations participating in the HMIS in Santa Clara County is required to file the CA Santa Clara County HMIS Client Consent.
To fill out the CA Santa Clara County HMIS Client Consent, clients must provide their personal information, review the consent form, understand the data sharing practices, and sign the document to authorize consent.
The purpose of CA Santa Clara County HMIS Client Consent is to ensure that clients are informed about how their information will be used and shared, and to obtain their permission for data collection and sharing for service provision.
The CA Santa Clara County HMIS Client Consent must report information such as the client's personal details, the types of services received, the agencies involved, and any agreements regarding data sharing and confidentiality.
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