HMIS Privacy Documentation

Below you will find the most recent privacy documents for our Continuum of Care with a brief description. For more information, please download the HMIS Privacy Documents Index or contact any one of the HMIS staff.

Document Type Revision Date

HMIS Notice of Privacy Practices (English)

HMIS Notice of Privacy Practices (Spanish)

doc October 22, 2019
     The Agency Privacy Notice explains how we use a client's data and must be available for any client who wishes to read them. You must also have a copy posted on your website.

HMIS Client Consent Form (English)
HMIS Client Consent Form (Spanish)

doc October 22, 2019
     This form is the client's consent or refusal to share information in HMIS with other agencies using HMIS.

HMIS Client Revocation Form (English)
HMIS Client Revocation Form (Spanish)

doc February 5, 2014
     This form may be signed by the client to revoke any previous consent they may have signed. It does not "un-share" previously shared data but does allow for agencies to restrict sharing moving forward.

HMIS Domestic Violence Notice (English)
HMIS Domestic Violence Notice (Spanish)

doc February 5, 2014
     This form must be in your intake documentation for any client to see. It does not need a signature.

Privacy Sample Sign (English)
Privacy Sample Sign (Spanish)

doc February 5, 2014
     Add your agency's information to this sign and make sure it is posted wherever you do client intake.

User Code of Ethics

doc February 5, 2014
     All users must have this confidentiality form signed and filed with their Agency before access to HMIS will be granted.