August 20, 2004
Every client your agency serves must read, understand, and sign this form before your agency may enter his or her information in the HMIS database. The purpose of the form is to ensure that all clients understand why they are being asked for the information collected in HMIS, and what it will be used for. When you serve multiple clients within the same family or household, the head of the household signs and gives consent on behalf of the other members of that household. Please photocopy this form and keep a supply on hand.