Issue Date: July 2009


2.4.B.1 Participant Information and Data

Each Teen REACH Participant must have a hard copy file. As the participant continues in the program, the file should be cumulative.

2.4.B.2. Confidentiality

The following information relating to participants and their families shall be treated as confidential: names and addresses individually or by list, information contained in program reports and files, information about financial resources, information contained in notes or other documents obtained from or about the participants and their family, records from the school and other institutions. Information shall be kept confidential except in the following cases: with the parent's written consent and if the confidential character of the information is preserved.

2.4.B.3. Release of Information

There must be a signed Release of Information Form (See Appendix) for each enrolled Teen REACH participant on file with the provider when communicating with a clinical or social service provider. Please note that for children 12 and over, their signature will be required when releasing information to clinical services, including mental health and family planning.

2.4.B.4. Written Program Consent Form

The Program Consent Form gives parental consent to participate in the activities of Teen REACH. The consent form shall include the name and relationship to the participant of the person signing the form, name and address of participant. The form must also include permission for: field trips; photography release; outcome measures; and medical release. There must be a signed Consent Form for each enrolled Teen REACH Participant with a valid signature, no more than 365 days old. (See Appendix)

2.4.B.5. eCornerstone Informed Consent

An eCornerstone Informed Consent Form must be completed and signed for each participant who is new in the program. If the form is not signed, basic demographic data entered into the system will not be shared with other programs. (See Appendix)

2.4.B.6. Academic Performance Data

Grade cards must be collected on enrolled Teen REACH participants, and kept on file. This information is recorded in eCornerstone