The following rights are guaranteed to you under Florida law. These will be fully explained to you at the time of and following admission to HOPE Services. A copy of this form will be given to you to keep.
All individuals who apply for Employment Services are assured that their lawful rights shall be guaranteed and protected regardless of race, color, ethnicity, national origin, age, creed, sex, sexual orientation, financial status, military status, or disability.
Individual Dignity: I have the right to be treated with dignity and respect, with access to all constitutionally protected civil rights. Federal law protects people with disabilities by the Americans with Disabilities Act.
Informed Choice: I have the right to request a change in the Employment Services provider by contacting my Vocational Rehabilitation Counselor.
Confidentiality of Information and Records: Without my written consent, HOPE Services will not reveal or distribute to any person or organization (with the exception of my Vocational Rehabilitation Counselor) any personal or professional information I provide to them.
Medical Treatment: I have the right to emergency medical treatment in the event that I should become ill or injured while in the presence of HOPE Services personnel. I will be provided any medical treatment deemed medically and immediately necessary. I am aware that I am financially responsible for such medical, dental, and/or transportation costs that result from such necessary treatment.
Firearms and Weapons: I understand and agree that no firearms or weapons are to be in my possession while meeting with, or engaging in employment activities with, HOPE Services personnel.
Drug Abuse: I understand that if I test positive for illegal drugs or am found with them in my possession while meeting with, or engaging in employment activities with, HOPE Services personnel, this will be reported to my Vocational Rehabilitation Counselor and HOPE Services has the prerogative to terminate their services to me.
Release of Responsibility: For me and my heirs and assigns, I hereby fully release HOPE Services from all claims and actions, which I now have or may have after signing this release. I intend to release all claims for injuries, damages, or lost to my person or property, whether foreseen or unforeseen, which I may have against HOPE Services while meeting with, or engaging in employment activities with, HOPE Services personnel. I have freely and voluntarily signed this release and I have had the chance to have it explained to me.