I understand Black River Area Development Corporation (BRAD) offers an Individualized and Case Management system designed to assist participants in positive lifestyle enabling activities with the ultimate goal of self-sufficiency.
The Case Management System is intended to help families and individuals seeking services with the agency to set goals based on needs and strengths.
A Needs Assessment will be conducted that will determine activities suited to the benefit of the client and family.
All information is kept confidential with the exception of the client's authorization to release information for verification purposes, court suboena, or if a family member is a threat to the safety of themselves or others.
I agree to participate in Black River Area Development Corporation's (BRAD) Case Management System for purposes of transitioning to self-sufficiency.
I will make contact with my Case Manager, and agree to be contacted by my Case Manager, on a periodic basis determined by the Case Manger, to keep my case record updated.
I understand I may be dropped from the Case Management System if I miss appointments, willingly do not make progress towards self-sufficiency goals, or if I am not receptive toward contact with my Case Manager.
Furthermore, I agree to grant permission to Black River Area Development Corporation (BRAD) to use my image (photos and/or video) for use in all agency media distribution deemed appropriate to communicate the success of my case by BRAD. I understand that before staff acquire images, I will be given the opportunity to opt out at that time, thereby removing myself from that particular media event.
I also acknowledge and I authorize the release of any and all information necessary for verification purposes.
This agreement between myself and BRAD will remain effective until rescinded or until I have reached goals sufficient enough to be interpreted as a successful transition into self-reliance. I understand that my case file is subject to review for purposes of assessing and monitoring program compliance.
I have read, understand, and agree to the above language.
