As a client of Working Against Violence for Everyone, W.A.V.E., you have the following rights regarding the confidentiality of your personal information and communications with W.A.V.E. staff and volunteers:
1. The information that you provide to W.A.V.E. will be kept confidential to the greatest extent allowed by law.
2. You may choose what information you want to provide to W.A.V.E. You will not be denied access to services if you choose to not provide certain identifying information.
3. The information that you provide to W.A.V.E. including your name, address, phone number, and other personal information will not be shared with other individuals or agencies without your permission.
4. W.A.V.E. staff may be required by law to report certain situations even if you don’t give them permission to share or report the situations, such as suspected child/vulnerable adult (elder) abuse or neglect. Staff and advocates will inform you of any reporting requirements prior to having conversations with you and will tell you when they must make a report and what information will be shared. Even when these reports are made, W.A.V.E. should not share information beyond what is required by law.
5. Some general information about the types of services provided and overall demographics (e.g., age and income ranges, average number of children, ethnicities) of people that use W.A.V.E. services must be shared with the agencies that fund W.A.V.E. However, information that specifically could identify you as someone who used W.A.V.E. services will never be shared unless specifically authorized in writing by you.
6. After your intake with W.A.V.E. you may choose to be referred to other agencies for additional help and support. You can decide how much or how little of your personal information W.A.V.E. will or will not be shared with each partner agency. You will be told, in general, what each partner’s obligations are to keep your information confidential. If you choose to have W.A.V.E. share some of your personal information with an agency we partner with, you will be told exactly how and what information will be shared. If you later decide that you don’t want the information you have provided to be shared with any of W.A.V.E. partners, let us know and we won’t share any more information with those partners.
7. Program staff shall protect a program participant’s confidentiality in the community and in public places, if you choose to acknowledge W.A.V.E. staff in public, we will acknowledge in return.
8. We ask that all participants respect the rights and confidentiality of others using WAVE services.
9. If you have any questions or concerns about this notice or your rights, or if you have a concern that your confidential information was not treated appropriately, please contact the Executive Director, firstname.lastname@example.org,
Client Notice of Rights/Confidentiality