I-KAN's Appendix Z Forms
Confidentiality (pdf)
  1. POLICY INFORMATION
    1. Subject:
    2. Policy:
    3. Procedure:
Current Status: Issued
Original Issue Date: 08/28/01
Reviewed: 08/28/02, 08//03, 08/04, 08/05, 08/06, 08/07, 08/09
Next Review Date: 08/28/10
Document Number: TR CON 02-VO1

POLICY INFORMATION

Subject:

Confidentiality of Information.

Policy:

It is the policy of the Iroquois-Kankakee ROE Teen REACH Program that all information related to Teen REACH participants provided to the Teen REACH Programwill be kept in the strictest confidence unless written permission is given for the information to be released.

Procedure:

  1. All Teen REACH staff will receive training on confidentiality of information. 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 files and reports, information about financial resources, information contained in notes or other documents obtained from or about the participants and their family, records from schools and other institutions.
  2. Confidential information will only be released with the express written consent of the parent/guardian. For children 12 and over, their signature will also be required when releasing information to clinical services, including mental health and family planning. Confidential information may be released to other agencies only if the confidential character of the information is preserved.
  3. Each enrolled participant must have a signed Release of Information Form (see Illinois Department of Human Services Teen REACH Policy and Procedures Manual Appendix ) on file with the program.
  4. All information will be kept in a non-public place.