The Projects for Assistance in Transition from Homelessness (PATH) Program participation in HMIS provides a platform for coordinating care and improving access to mainstream programs and housing resources and supports the generation of the PATH Annual Report. HMIS Client Consent Form with Supplemental.pdf. www . A list of agencies participating in HMIS that may have access to your information if you sign this authorization is at . wisp@icalliances.org Log into Service Point . Data sharing is the ability to transfer data from one agency to another electronically through HMIS. While the general HMIS ROI does not require a written signature, there may be other data privacy and sharing requirements in effect that are specific to your agency.
Facilitators, best practices and barriers to integrating family A Homeless Management Information System (HMIS) is an online database that enables organizations to collect data on the services they provide to people experiencing homelessness and people who are at risk for homelessness. Coordinated Entry System. BTG has chosen CaseWorthy as its HMIS solution. LB HMIS Consent & LB ROI Page 1 of 4 Revision 20201110v5 .
PDF Homeless Management Information Systems - Implementation Guide - Glossary A current list of Partner Agencies is at
Homeless Management Information System (HMIS) View HUD's HMIS Standard Reporting Terminology Glossary. For Agencies/Projects Not Currently Set Up in HMIS: For Agencies/Projects Currently Set Up in HMIS: Data and Performance Management Meeting Materials, Article: HMIS Requirements for New Agencies.
PDF PA HMIS Collaborative Client Consent - Pennsylvania Continuums of Care Tourist and convention development tax return (for registered taxpayers only) Once completed and signed, please fax or mail to the number or address on the form. HMIS Project Set Up Form HMIS Grant Set Up Form HMIS Bed & Unit Inventory Update Form HMIS User Access Request Form New User Request Form User Policy Responsibility Statement HMIS Client Consent & ROI Client Informed Consent & Release of Information (English) Client Informed Consent & Release of Information (Spanish) HMIS CES Verification Form . The HMIS code migration is scheduled for Tuesday January 3rd, 17th & 31st. HMIS.
Forms PARTNERS IN CARE PART II - YOUR CONSENT Basic Information: This information will be shared through HMIS and with members of the Collaborative. Client Informed ConsentEach client must sign this form to consent to, or deny, the collection of his or her personally identifying information; form should be available in other languages as needed. There was a problem submitting your feedback. HMIS Resource If you would like to get more technical support on the Homeless Management Information System (HMIS) please visit the OC HMIS Help Desk Knowledge Base . DCED Library Homeless Management Information System (HMIS) - Intake Form. Resources and assistance to support HUD's community partners. A Client Consent to Data Collection and Release of Information (ROI) must be completed for each client who consents to have their personally identifying information (PII) entered into the King County HMIS System. This form can be used to request ad hoc analysis or to develop new custom reports or dashboards. Client/server system: Architecture in which the client and server computers are connected via a LAN or It allows the Agency to use HMIS, assigning rights to user licenses. What's new HMIS documentary Digital Learning - New HMIS Portal Latest Technical note released on: Wed, Dec 04, 2019 for Version 8.6.7 2M#/oko|y;3n64k' Jy92*Qtyo/cwR-.MOD0MRVQ*m9I'e9. All questions must have an answer in order to save - please choose N/A where needed. The following forms must be completed and submitted to the HMIS admin team if new users require access to the system or if duplicate clients require merging. Vice President, Data Analytics.
HMIS Administrative Documents data | Raleigh, North Carolina USA - NCCEH Household DHS HS Entry - Housing and Supportive Services, Household DHS HS Interim - Housing and Supportive Services, Household DHS HS Exit - Housing and Supportive Services, Single DHS HS Entry - Housing and Supportive Services, Single DHS HS Interim- Housing and Supportive Services, Single DHS HS Exit - Housing and Supportive Services, Household DHS HS Entry - Emergency Shelter, Household DHS HS Exit - Emergency Shelter, Instructions: Last Updated August 15, 2022, DHS-HS HMIS User Guide for Housing and Supportive Services, DHS-HS HMIS User Guide for Emergency Shelter, Maia Uhrich: Housing and Support Services, Household LTHSSF Entry: Doc | Fillable PDF, Household LTHSSF Interim: Doc | Fillable PDF, Household LTHSSF Exit: Doc | Fillable PDF, Single LTHSSF Interim: Doc | Fillable PDF, Household SOR Entry - Street Outreach Projects: Doc | Fillable PDF, Household SOR Entry - Services Only Projects: Doc | Fillable PDF, Household SOR Interim: Doc | Fillable PDF, Single SOR Entry - Street Outreach Projects: Doc | Fillable PDF, Single SOR Entry - Services Only Projects: Doc | Fillable PDF, Instructions: Last Updated August 17, 2022, Household ESP Entry - Emergency Shelter & Street Outreach Projects: Doc | Fillable PDF, Household ESP Entry - All Other Project Types: Doc | Fillable PDF, Household ESP Interim: Doc | Fillable PDF, Single ESP Entry - Emergency Shelter & Street Outreach Projects: Doc | Fillable PDF, Single ESP Entry - All Other Project Types: Doc | Fillable PDF, DHS-OEO ESP HMIS User Guide for Rapid Rehousing and Homelessness Prevention, DHS-OEO ESP HMIS User Guide for Emergency Shelter and Street Outreach, Katelyn Warburton, State Program Administrator: katelyn.warburton@state.mn.us, Rabya Hassen,Homeless Grant Program Manager: Rabya.N.Hassen@state.mn.us, Household THP Interim: Doc | Fillable PDF, Instructions: Last Updated August 12, 2022, Annie McCabe, Homeless Grant Program Manager: Ann.E.McCabe@state.mn.us, PATH Street Outreach (SO) Entry-Exit Form: Doc | Fillable PDF, PATH Street Outreach (SSO) Entry-Exit Form: Doc | Fillable PDF, RHY Single Entry/Exit Combined - BCP-Prevention/TLP/MGH Programs: Doc | Fillable PDF, RHY Single Entry/Exit Combined - BCP-Emergency Shelter Programs: Doc | Fillable PDF, RHY Single Entry/Exit Combined - Street Outreach Programs: Doc | Fillable PDF, Family and Youth Services Bureau (FYSB)Website, Household HUD CoC Entry: Doc | Fillable PDF, Household HUD CoC Interim: Doc | Fillable PDF, Household HUD CoC Exit: Doc | Fillable PDF, Single HUD CoC Interim: Doc | Fillable PDF, Household ESG Entry - Emergency Shelter & Street Outreach Projects: Doc | Fillable PDF, Household ESG Entry - All Other Project Types: Doc | Fillable PDF, Household ESG Interim: Doc | Fillable PDF, Single ESG Entry - Emergency Shelter & Street Outreach Projects: Doc | Fillable PDF, Single ESG Entry - All Other Project Types: Doc | Fillable PDF, Instructions: Last Updated November 2, 2022, HUD-ESG HMIS User Guide for Homelessness Prevention and Rapid Rehousing, HUD-ESG HMIS User Guide for Emergency Shelter and Street Outreach, HUD- ESG HMIS User Guide for Night-by-Night Emergency Shelter , Household HOPWA Entry - Emergency Shelter & Street Outreach Projects: Doc | Fillable PDF, Household HOPWA Entry - All Other Project Types: Doc | Fillable PDF, Household HOPWA Interim: Doc | Fillable PDF, Singles HOPWA Entry - Emergency Shelter & Street Outreach Projects: Doc | Fillable PDF, Singles HOPWA Entry - All Other Project Types: Doc | Fillable PDF, Singles HOPWA Interim: Doc | Fillable PDF, Hennepin County Single YHDP Entry/Exit Combined, Household VASH Entry/Exit Combined: Doc | Fillable PDF, Household VASH Interim: Doc | Fillable PDF, Single VASH Entry/Exit Combined: Doc | Fillable PDF, Household FHPAP Entry: Doc | Fillable PDF, Household FHPAP Interim: Doc | Fillable PDF, Household FHPAP Entry/Exit Combined: Doc | Fillable PDF, Single FHPAP Entry/Exit Combined: Doc | Fillable PDF, Street Outreach Single FHPAP Entry/Exit Combined: Doc | Fillable PDF, Instructions: Last Updated September 27th, 2022, Minnesota Homeless Prevention Assessment Tool (M-PAT) Guide, Household HSWH Interim: Doc | Fillable PDF, Instructions: Last Updated November 7, 2022, Homework Starts with Home HMIS User Guide, Videos: Homework Starts with Home Data Entry Demo, Household LTH Interim: Doc | Fillable PDF, High-Priority Homeless Form Instructions (video), Instructions:Last Updated August 15, 2022, Household MN Universal Entry - Emergency Shelter and Street Outreach Projects: Doc | Fillable PDF, Household MN Universal Entry - All Other Project Types: Doc | Fillable PDF, Household MN Universal Interim: Doc | Fillable PDF, Household MN Universal Exit: Doc | Fillable PDF, Single MN Universal Entry - Emergency Shelter and Street Outreach Projects: Doc | Fillable PDF, Single MN Universal Entry - All Other Project Types: Doc | Fillable PDF, Single MN Universal Interim: Doc | Fillable PDF, Single MN Universal Exit: Doc | Fillable PDF, Hennepin Single Adult Shelter Instructions: Last Updated November 1st 2022, HCC Shelter Training: Checking-in a Client with an ASC Reservation, HCC Shelter Training: Managing Clients in ShelterPoint, Hennepin Single Adult Shelters (for both night-by-night and extended stay programs), General ShelterPoint Instructions: Last Updated January 7th, 2022. The document informs clients about services, fees, records, and limitations that may affect the client.
HMIS Policies and Forms - Westchester Continuum of Care Partnership for A Homeless Management Information System (HMIS) is a secure online database that stores data on all homelessness services that are provided in Santa Clara County. Client Consent To Data Collection And ROI, How to add an Electronic Signature ROI (PDF), How to add an Electronic Signature ROI (Video).
Data-Sharing Standards, Agreements and Examples Information collected in the HMIS database is protected in compliance with the standards set forth in the Health Insurance Portability and Accountability Act (HIPAA) and the U.S. Department of Housing and Urban Development HMIS Data Standards.
HMIS - CSA Main 1 MB Download.
Forms - Volusia County, Florida x]&qWZF>/ifi5oS @f) HMIS Administrative Documents - Use and Bookmark our ServicePoint link hmisncceh.servicept.com! Dependent children under 18 in household, if any (Please print first and last names): . Continuum of Care. Personal Identifying Information (Name, Social Security Number, Date of Birth, Gender, Veteran Status, photo) Personal identifying information about your dependents (if applicable) (Note: Anyone 18 years of age or older must sign a separate consent form.) Please contact mnhmis@icalliances.org if you need assistance filling out this form. Request to waive penalty. Forms & Documents for Agency Administrators, Santa Clara County CoC Continuous Data Quality Improvement Process, VI-SPDAT (Replaces H1K Vulnerability Index), Justice Discharges VI-SPDAT (JD-VI-SPDAT), SPDAT Forms (Replaces Self-Sufficiency Matrix), Homeless Prevention Assessment Tool (HPAT), Homeless Prevention Services Program (HPS), HHS Runaway and Homeless Youth Program (RHY), SAMHSA Projects for Assistance in Transition from Homelessness (PATH), Clarity HMIS: HUD-CoC Congregate NCV Program Intake (Back Data Entry), Santa Clara County Community Queue Referrals - Standard Location Practices, Domestic Violence, Sexual Assault, and Human Trafficking Pre-Screening Tool and Referral Guide, How to Create an Anonymous Client Profile, How To Fix Common Annual Assessment Errors, Victim Services Screening Tool and Training, How to ask well-being questions in PSH Enrollment, Bed and Unit Inventory (BUI) Update Form (2021), 2022 HMIS Data Standards- Data Dictionary, HMIS Standard Operating Procedures (SOPs), SCC HMIS Partner Agency Privacy and Data Sharing Agreement, Technical Administrator and Security Officer Agreement, SCC HMIS Quarterly Compliance Certification Checklist, SCC HMIS Quarterly Compliance Self Certification, Santa Clara County Agency Admin.
PDF Client Consent to Release Information - CONNECTIONS FOR THE HOMELESS })
HMIS Training: Completing the Electronic Consent Form 319 views Jan 9, 2019 2 Dislike Share Save Ending Homelessness 81 subscribers This five minute video provides training on how to complete the. MEASURE Evaluation worked in Ethiopia to implement a HMIS in the Southern . Learn about what HUD grantees are doing across the nation. What information is collected and how it is used is described in the HMIS@NCCEH . The HMIS and CES are shared homeless and
Governance. Please try again later.
HMIS Forms and Documents - Orange County HMIS Client .
Find answers to frequently asked questions. Section 4.2.4 of the2004 HUD Data and Technical Standards Noticeallows for retroactive application of amendments to the privacy notice, stating, A CHO must state in its privacy notice that the policy may be amended at any time and that amendments may affect information obtained by the CHO before the date of the change. may be made locally by the CoC, working in conjunction with the HMIS Lead, and should also consider possible state or other local requirements. If you have any questions and/ or are a part of a participating agency that needs assistance utilizing HMIS, please contact the HMIS Help Desk at 410.396.HMIS (4647) or email HMIS Support. You have the right to see your information in the HMIS, ask for changes, or ask for a printed copy upon request. and my refusal to consent does not disqualify me from receiving services. page of this form.Report developers and HMIS staff may also see your d ata. Browse the library of grantee reports and plans, organized by program. Santa Clara County uses this data to improve the ability of local organizations to provide access to housing and services, and strengthen our efforts to end homelessness.
Since its inception in 2004, BTG has utilized the HMIS to collect client-level data, as well as data on the provision of housing and services to at-risk and homeless individuals and families. KMNH has developed an extensive collection of reports and dashboards that may already meet your needs. }), Presidents Day - Mon, Feb 20, 2023Prince Kuhio Day - Fri, Mar 24, 2023 (Observed)Memorial Day - Mon, May 29, 2023, Copyright 2023 Bridging The Gap Hawaii |, Prince Kuhio Day - Fri, Mar 24, 2023 (Observed), BTG Client Informed Consent Form (Jun 2018), BTG Custom Data or Report Request Form (Apr 2019), HPO Memo Re: Consent to Share Privacy Forms - 11.1.17, BTG HMIS New User Agreement and Training Request Form (Feb 2020), BTG Duplicate Client ID Merge Form (Jul 2018), FY 2022 HMIS Data Standards Manual (Sep 2021), PATHHMISProgram Specifications (Jun 2019), Adult - TH, RRH, Non-CoC Program Funded PSH & HP, Adult - ES, TH, RRH, & Non-CoC Program Funded PSH, BTG Additional Family Member Form (Sep 2021), BTG SPDAT Individual Assessment (Nov 2020), BytePages Content Management System Powered by Byte Productions.
food pantry programs in Essex, md | findhelp.org Client Consent and the HPAT: What can I enter into HMIS? sg+QN y]ZU(_,iOw0*'%
|xw/"402wu1*y@R,)
?cmJ*J@
d@4FET~2ZREKdW^8>+V$lL)'+F7e;xtbYiyRn^a$Vh|oF This consent is valid for seven (7) years from the . Client Revocation of HMIS ConsentIf a client decides to revoke consent, they must sign this form. Client Consent and Data Privacy Notice documents are on the Administrative Documents page.
HMIS Sample Forms - Bitfocus 800-594-9854 Ext. the GA HMIS as described in this consent form. LA-HOP. With this form, you can give permission to have information about you collected and shared with Partner Agencies that help King County provide housing and services. anyone in need.
PDF Client Release of Information and Informed Consent Client Consent for HMIS@NCCEH data | Raleigh, North Carolina USA Client Consent to Data Collection & ROI (2020), Online Fillable Client Consent to Data Collection and ROI (2020), Department of Veterans Affairs Release of Information, Consent Refused Data Entry Guide (updated 6Sept2019). Search for a specific grantee and view itsawards, contact information, and reports, and more. NCCEH uses DocuSign to electronically gather signatures. CNYHMIS Client Consent Form Client Name: _____ Date of Birth:_____ Agency: _____Program: _____ I know that this agency is part of the CNY HMIS (Homeless Management information System). The following consent forms and policy documents support specific confidentiality and security standards to protect and inform both the client and provider. Homelessness is solvable, and by acting together as a community, all people can have a home. Authorized Power of Attorney or Proxy notarized letter from Client along with signed HMIS consent form. With your consent, your personal information, including historical information in HMIS, will be made available to other agencies providing services to you through HMIS. Institute for Community Alliances
PDF State of Hawaii Homeless Management Information System (Hmis) Bridging o A copy of your consent form o A copy of your HMIS record (agency staff must review this information with you if you request such a review
Homeless Management Information System (HMIS) CES Partner Documents and Resources - Health Care Agency One of these forms must be completed for EACH funding source/grant within the agency project that will be using HMIS. Appalachian Regional Commission Program (ARC) Community Development Block Grant (CDBG) Community Development Block Grant-Mitigation (CDBG-MIT) Emergency Solutions Grant (ESG) Housing Opportunities for Persons with HIV/AIDS (HOPWA) HUD Consolidated Plan and Executive Summary. Register for upcoming training, webinars, conferences, and more.
HMIS Forms & Manuals | CARES of NY, Inc. Don't Miss: Corpus Christi Food Bank Donation. The FY 2022 HMIS Data Standards have an effective date of 10/1/2021. If I need to be referred to another agency for services, my information will be forwarded to only 5 0 obj HMIS empowers agencies to track key indicators on homelessness so they can deliver . Learn through self-paced online trainings, recorded webinars, and more. 2023. Find point of contact information for HUD's grantees. 2021 CNY HMIS Entry DV Bonus Assessment, 2021 CNY HMIS Entry TH, HP & SSO Programs for Adults & HoH, 2021 CNY HMIS Entry Assessment for Adults & HoH Cayuga County Emergency Shelters, 2021 CNY HMIS Entry Assessment for Adults & HoH Tompkins County Emergency Shelters, 2021 CNY HMIS Entry Assessment for Children under 18, 2021 CNY HMIS Entry SO ONLY Assessment for Adults & HoH, 2021 CNY HMIS ES Entry Assessment for Adults & HoH, 2021 CNY HMIS HHS RHY Entry Assessment Child of Parenting Youth, 2021 CNY HMIS HHS RHY ES & SO Entry Assessment HoH or Single Youth, 2021 CNY HMIS HHS RHY TH & HP Entry Assessment HoH or Single Youth, 2021 CNY HMIS PSH Entry Assessment for Adults & HoH, 2021 CNY HMIS PSH Entry Assessment for Children under 18, 2021 CNY HMIS RRH Entry Assessment for Adults & HoH, 2021 CNY HMIS HHS RHY Annual.Update Assessment HoH or Single Youth, 2021 CNY HMIS HHS RHY Follow-up Assessment HoH or Single Youth, 2021 CNY HMIS PSH Update Annual Assessment for Adults & HoH, 2021 CNY HMIS SO ONLY Update Annual Assessment for Adults & HoH, 2021 CNY HMIS Update Annual Assessment for Adults & HoH, 2021 CNY HMIS Update ES, HP, TH, & SSO Annual Assessment for Adults & HoH, 2021 CNY HMIS Update. Next Steps: Call 410-686-2867. Households How-To GuideThis guide explains how to manage households in HMIS. `RQ$7;k+g?Ew?J?=T'{z%QqRdO}EI;a[mq]l[ policies and corresponding procedures that are appropriate locally and that are compliant with federal, state, and local law. PA HMIS Collaborative Client Consent Release of Information via PA HMIS If I decline to release my information, it will be hidden from all other PA HMIS participating agencies, except in the case of a referral. To comply with this requirement Kitsap County agencies that provide homeless housing and services participate in the Kitsap HMIS Collaborative, an agreement to share client data between agencies. Please send all requests for changes to support@bitfocus.com.
HMIS Documents | The Housing and Homeless Coalition of Central New York Click here to see examples of completed ROIs. Agencies should refer first with their own data privacy agreements, then any data sharing arrangements theymay have. Policy. Funding. Explore collections of guided learning opportunities on a variety of topics. Due to the nature of UHMIS, when client consentends, this agency will share no new information,but this agency will not remove anything already shared within the system. Please have the following readily available as you complete this form: The staff person at your agency who can provide accurate information and answer questions about the project; Knowledge of the funding source, including when the grant starts/started; For federally-funded projects, the grant identifier from your contract or grant; For shelters and housing projects, knowledge of the number of beds and units per this funding source. There is a clear purpose, as well as use limitations. Request in-depth assistance with implementing a HUD-funded program. HMIS. You have the right to receive a copy of this consent form. The Baltimore City Mayor's Office of Homeless Services serves as the HMIS Lead Agency for the Baltimore City Continuum of Care. Decisions regarding permitted types of consent (inferred, written, verbal, etc.) Please have the following readily available as you complete this form: Homeless Programs Reporting ScheduleCheck out this resource for information on upcoming report deadlines. System Administration provided by Bitfocus, Inc. Coordinated Entry System. Client Informed Consent FY 2021-2022. Veterans By Name. Electronically: A client can consent by reviewing and signing the ROI form electronically in HMIS. Effective Wednesday, July 5, 2017, all Homeless Providers contributing data into HMIS are required to use this new form. I have the right to .
PDF Wisconsin HMIS Client Informed Consent and Release of Information WI HMIS includes your demographic information and other essential personal information needed to best determine your service needs. Partners In Care, 200 N Vineyard Blvd Suite A-210, Honolulu. Homelessness is solvable, and by acting together as a community, all people can have a home. While the general HMIS ROI does not require a written signature, there may be other data privacy and sharing requirements in effect that are specific to your agency. The Housing and Homeless Coalition of Central New York (HHC) serves the City of Syracuse, the County of Onondaga, the City of Auburn, the County of Cayuga and the County of Oswego. This document can be used as a community example, but it has not been approved or endorsed by HUD. HUD FAQ
Privacy Policy and Client Consent Form - Helpdesk - All Chicago HMIS Privacy & Data Sharing Overview - Client Consent Form attached at the bottom, Password: Reach out to your System Administrator.
2016 The Housing and Homeless Coalition of Central New York. Closed Today See open hours. Guidance included in the following documents aligns with HMIS requirements as stated by the Substance Abuse and Mental Health Services Administration (SAMHSA): The following entry/assessment and corresponding exit forms are intended to capture specific program requirements in each category: adults, youth and children.
HMIS Client Consent Form: Informed Consent Agreement (Sample) Legislative Affairs MyOrg. Minnesotas HMIS is a collaborative project of the 10 Minnesota Continuums of Care, the Minnesota Tribal Collaborative to Prevent and End Homelessness, the State of Minnesota, the Institute for Community Alliances, and participating partner agencies. The CNY HMIS is a system that uses computers to collect information about homelessness in order to help plan and pay for services to . Agency Agreements Agency Participation Agreement (Sample)This form is an agreement between an agency and NCCEH. HMIS. Homeless Management Information System (HMIS) Client Consent Form Template (to be printed on Agency letterhead) Client Name: ___________________________________ Date of Birth:____________ Household members: Name__________________________________________ Date of Birth:_________________ Name__________________________________________ Date of For technical support contact nevada@bitfocus.com. General HMIS InstructionsA guide with information about basic HMIS features and step-by-step instructions for common data entry activities. HMIS Privacy Policy- The goal of HMIS Privacy Policies and Procedures is to ensure confidentiality and security of all client data captured in HMIS in conformity with all current regulations related to privacy and data confidentiality rights. Your consent allows your record to be updated by any participating organization with which you interact without you being required to sign another consent form. Request in-depth assistance with implementing a HUD-funded program. The Can Food Pantry is here to serve and assist you.
HMIS-Health Management Information System Additionally, make sure theData Privacy Noticeis available to clients at intake, even if an intake is being conducted over the phone.
Privacy & Security | Mayor's Office of Homeless Services By signing this form, I give this Agency permission to share (verbally, or through the HMIS, mail, fax, or by hand) information collected about me and any dependents listed on the back of this form with HMIS Partner Agencies, for the Legislative Affairs MyOrg. This form allows the Institute for Community Alliances (ICA) to configure data collection appropriately for agencies in the database. Copyright 2020 Institute for Community Alliances. All rights reserved. HMIS Privacy & Data Sharing Overview - Client Consent Form attached at the bottom What does it mean to share data? Visit the FY 2022 HMIS Data Standards Changes page.
HMIS Training Evaluation Survey - SurveyMonkey Policy.
PDF Chicago Homeless Management Information System Client Consent for Data Helpful Links Contacts HMIS Help Desk 714-589-2360 Erin DeRycke Elizabeth Duong
Resources | West Virginia Community and Development Office - WV CAD PDF CNYHMIS Client Consent Form - hhccny.org We are the organized body of informal networking and formal linkages between homeless services providers and other public and private human service providers.
HMIS Training: Completing the Electronic Consent Form - YouTube 2023 US Department of Housing and Urban Development, Client Consent Form: Informed Consent (Sample), HMIS Client Consent Form: Informed Consent Agreement (Sample).