Limits of Confidentiality Information will be released under the following circumstances:
1. Upon presentation of an authorized "Consent to Release Information" form signed by the parent/guardian or volunteer.
2. For promotional purposes with a signed copy of the “Consent to Use Identifying Information” form.
3. For purposes of program/case review, evaluation, audit, or accreditation to Big Brothers Big Sisters of America, the Board of Directors, Program Committee and funding sources.
4. Pursuant to a valid and enforceable subpoena.
5. To agency legal counsel in the event of litigation or potential litigation involving the agency. Such information is considered privileged information and its confidentiality is protected by law.
6. Identifying information necessary to comply with state laws mandating reporting suspected child abuse. The agency staff will follow reporting requirement of their respective jurisdiction and will comply with mandated procedures.
7. Upon receipt of information that a client or volunteer may be dangerous to himself/herself or to others. Necessary steps may be taken to protect the appropriate party, which may include a medical referral or a report to the local law enforcement authorities.
8. At the time a child or volunteer is considered as a match candidate, the following information is shared between prospective match parties.
Volunteer: Age, gender, race, religion, sexual orientation, interests, household composition, reason for application, special skills, life threatening illnesses, employment and specific information that would affect the match relationship;
Parent/ client: age, gender, race, religion, interests, living situation, needs and expectations for the match, life threatening illnesses, and school or family information that would affect the match relationship. A copy of this information profile sheet will be provided to you at your request.
I agree to keep all information regarding a potential Big Brothers Big Sisters match confidential. I will not discuss this information with any other person other than the assigned professional staff. I have read and understand the above document. I agree to program participation under the conditions it sets forth.