Home → Forms → Acknowledgment of Data Collection and Consent to Share → Data Privacy Notice, Acknowledgment, and Consent
This document contains the following components:
Staff Instructions
Client Rights Information
In-Person Acknowledgment of Data Collection and Consent to Share
Verbal Acknowledgment of Data Collection and Consent to Share
Posted Data Privacy Notice
Clients should complete the Acknowledgment of Data Collection and Consent to Share before their information is entered in HMIS. Clients should complete this form yearly. A verbal (over the phone) version is available on Page 4 of this document.
The Posted Data Privacy Notice must be displayed in your agency's client intake area.
Please email feedback, suggestions, or new form requests to hmis@cohhio.org.