I understand that all information (written and verbal) about participants at this PATH center is confidential. Client files may be accessed by Giant Steps instructors and staff but will not be shared with anyone without the expressed written consent of the participant and their parent/guardian in the case of a minor. Limitations to this confidentiality policy are as follows:
In our commitment to equity and inclusion, we track data on our clients, volunteers, and staff. This data is merely for us to evaluate our progress on our equity and inclusion work.It does not affect your application in any way, and is completely voluntary to complete.
Expiration: This authorization is ongoing unless cancelled in writing by the client.
Restrictions: Providers who receive this information may not release it to someone else unless another authorization form is signed.
Your Rights: You may refuse to sign this form. You may cancel it at any time by informing Giant Steps Therapeutic Equestrian Center in writing. If you cancel your permission to allow the release of information about you / your child, it will go into effect immediately (unless someone already released information). You have the right to receive a copy of this Authorization