HMIS Forms

Forms related to HMIS and Safe Harbors are listed below. If you cannot find a form here that you would like, please contact the Help Desk to make a request.

Forms and Guidance

Last Update Document Document Type Description Language MS Word PDF
Client Consent
02/03/2011 Client Release of Information Form Client Information Consent form English Download Download
01/13/2012 Client Release of Information Form Client Information Consent form -Chinese- (Simplified) Download Download
01/13/2012 Client Release of Information Form Client Information Consent form -Chinese- (Traditional) Download Download
01/13/2012 Client Release of Information Form Client Information Consent form -Spanish- Download Download
01/13/2012 Client Release of Information Form Client Information Consent form -Tagalog- Download Download
01/13/2012 Client Release of Information Form Client Information Consent form -Vietnamese- Download Download
11/8/2010 HMIS Client Privacy Rights Form Explanation for Client Privacy Rights English Download
01/13/2012 HMIS Client Privacy Rights Form Explanation for Client Privacy Rights -Chinese- (Simplified) Download Download
01/13/2012 HMIS Client Privacy Rights Form Explanation for Client Privacy Rights -Chinese- (Traditional) Download Download
01/13/2012 HMIS Client Privacy Rights Form Explanation for Client Privacy Rights -Spanish- Download Download
01/13/2012 HMIS Client Privacy Rights Form Explanation for Client Privacy Rights -Tagalog- Download Download
01/13/2012 HMIS Client Privacy Rights Form Explanation for Client Privacy Rights -Vietnamese- Download Download
Client Consent Revocation
10/18/2010 Revocation of Client Consent Form Form Revoke Client Consent English Download Download
01/13/2012 Revocation of Client Consent Form Form Revoke Client Consent -Chinese- (Simplified) Download Download
01/13/2012 Revocation of Client Consent Form Form Revoke Client Consent -Chinese- (Traditional) Download Download
01/13/2012 Revocation of Client Consent Form Form Revoke Client Consent -Spanish- Download Download
01/13/2012 Revocation of Client Consent Form Form Revoke Client Consent -Tagalog- Download Download
01/13/2012 Revocation of Client Consent Form Form Revoke Client Consent -Vietnamese- Download Download
Information
03/08/2011 Informed Consent Frequently Asked Questions (FAQ) Information Information on Informed Consent Policies English Download
9/29/2010 Revocation of Client Consent Procedure Information Information sent to all Programs affected by Consent Revocation English Download
03/08/2011 One page description of Safe Harbors for clients Information Informational handout for Clients about Safe Harbors HMIS English Download
01/13/2012 One page description of Safe Harbors for clients Information Informational handout for Clients about Safe Harbors HMIS -Chinese- (Traditional) Download
01/13/2012 One page description of Safe Harbors for clients Information Informational handout for Clients about Safe Harbors HMIS -Chinese- (Simplified) Download
01/13/2012 One page description of Safe Harbors for clients Information Informational handout for Clients about Safe Harbors HMIS -Spanish- Download
01/13/2012 One page description of Safe Harbors for clients Information Informational handout for Clients about Safe Harbors HMIS -Tagalog- Download
01/13/2012 One page description of Safe Harbors for clients Information Informational handout for Clients about Safe Harbors HMIS -Vietnamese- Download
Program and User Administration
11/7/2011 Standard Operating Procedures (SOP) - updated June 15, 2011 Information Requirements, Responsibilties and Procedures related to the Safe Harbors HMIS English Download
5/5/2010 New User Setup Form Form User Information English Download
6/4/2009 User Responsibility & Code of Ethics Agreement Form Needed for Username and Password English Download
Custom Report Request
10/18/2010 HMIS Report Request Form Form Needed for Custom Report Requests English Download Download
Safe Harbors User Guide
11/08/2011 Safe Harbors HMIS Guide (Version 1.6) Information User guide for Training and Use of Safe Harbors HMIS English Download


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