READ FIRST: Before you decide whether or not to let Voices Against Violence share some of your confidential information with another agency or person, an advocate at Voices will discuss with you all alternatives and any potential risks and benefits that could result from sharing your confidential information. If you decide you want Voices to release some of your confidential information, you can use this form to choose what is shared, how it's shared, with whom, and for how long.
I understand that Voices Against Violence has an obligation to keep my personal information, identifying information, and my records confidential. I also understand that I can choose to allow Voices Against Violence to release some of my personal information to certain individuals or agencies.