HopeLink

Housing Intake – Client Privacy Policy Form

Client Privacy Policy Form

Client Privacy Policy Form

Housing Intake - Client Privacy Policy Form

At HopeLink of Southern Nevada, we respect the privacy of all clients participating in the Rapid Rehousing program. We are committed to protecting the personal information you provide to us and ensuring it is handled safely and confidentially.

1. Information Collected

We may collect the following information to provide housing and supportive services:

  • Personal identification (name, date of birth, social security number, etc.)
  • Contact information (address, phone, email)
  • Household information (family members, income, housing status)
  • Health or disability-related information (if necessary for accommodation)
  • Case notes and program records
  • HMIS (Homeless Management Information System) data: Your information will be entered into the HMIS database to help coordinate services across agencies.

2. Use of Information

Information you provide is used only for:

  • Determining eligibility for Rapid Rehousing services
  • Providing case management and supportive services
  • Reporting to funders as required by law (e.g., HUD, local agencies)
  • Program evaluation and improvement
  • Coordinating services through the HMIS database

3. Confidentiality

  • All client information is treated as confidential.
  • Information will only be shared with your consent or as required by law.
  • Staff are trained to protect client privacy and comply with HIPAA, HUD, HMIS, and other applicable privacy laws

4. Sharing Information

Your information may be shared with:

  • Program staff for case management
  • Partner agencies provide services as part of your housing plan with your consent.
  • Funders or oversight bodies, in aggregate or de-identified form whenever possible.
  • Authorized users of the HMIS database for service coordination.

5. Your Rights

  • You have the right to review your own records.
  • You have the right to request corrections to your information.
  • You may request restrictions on how your information is used or shared.

6. Security Measures

  • Hopelink uses physical, electronic, and procedural safeguards to protect your personal information from unauthorized access, disclosure, or misuse, including HMIS data security protocols.

7. Contact

If you have questions about this privacy policy or wish to exercise your privacy rights, please contact:

Tiffany Simmons – Director of Housing Services
Phone: 702-566-0576 ext. 1004
Email: Tiffany@link2hope.org

Acknowledgement


Client Name Signature

Client Name Signature

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