Client Rights at DVSAS

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Your Rights at DVSAS:

At DVSAS you will be treated with respect. We do our best to provide services to anyone who needs them and we do not discriminate for any reason. We can also provide services to your friends and family members, including children. DVSAS Services are free.

  • You have a legal right to privacy and confidentiality.

Washington State Law protects your privacy and the confidentiality of the information that you share with anyone at DVSAS. We will maintain complete confidentiality, UNLESS:

  1. You talk to an advocate and give us written permission to share your information with someone.
    1. If you do this, you do not give up your right to have your information protected under other statutes, rules or laws.
    2. You never have to agree to release your information to anyone in order to receive any service at DVSAS.
    3. You have the right to withdraw your permission to release your information at any time.
  2. We are mandated by law to report known or suspected abuse of a child (under 18) or a vulnerable adult. In this case, we will call Child Protective Services, Adult Protective Services and/or law enforcement.
  3. We believe that you may hurt yourself or someone else. In this case, we will call law enforcement and/or the Designated Mental Health Professional.
  4. A court of law orders us to release your information. If our staff or your file is subpoenaed it is our policy to take all available legal steps to protect your information. If this happens we will do our best to contact you and help you make a safety plan.
  • You have a right to know what information we keep about you and where we keep it:
  1. You do not have to us give your name or any personal information to receive services.
  2. We keep client files that contain intake information, brief information on received services and copies of signed documents, like this notice and releases of information.
  3. We use this information to help coordinate services, create statistical reports, verify services to funders, and to plan and evaluate our services. We do not use any personal information on reports.
  4. We keep all of our client files in a secure locked place where only authorized people have access to them. We also maintain a secure, password-protected data base.
  5. Files stay in our facilities at all times and are transported between facilities by authorized personnel when necessary.
  6. We keep your file for 7 years after you stop coming for services.
  • I have a right to see my file:

All original documents have to stay in your file but we can make photocopies for you at your written request. An advocacy counselor will stay with you while you review your file and we will document your review time.

  • I have a right to make a suggestion, complaint and/or to file a grievance:
  1. You can fill out a suggestion or complaint and put it in the suggestion box.
  2. If you feel you are ever treated unfairly here, we want to know. Please ask to see, or call the Program Supervisor or the Executive Director. If that does not help, please ask the receptionist for a Client Grievance Form which has directions on how to file a complaint.
  • Images and Public Appearances:

Sometimes, clients choose to share their story in a DVSAS publication or event. However, we will never use your story, photos, or videotapes without your expressed written consent.

Consent for Services: You are not required to receive services; your participation is completely voluntary. Sign below if you consent to receive services from DVSAS. If you are under 13 years old or are an adult with a guardian appointed for personal decision making, your parent or guardian must sign to consent for you.