Individual/Participant whose information is to be disclosed:
I authorize Denver Workforce Services and its contracted service providers (including, but not limited to: Ability Connection Colorado, Center for Employment Opportunities, Denver Public Schools, Urban Peak, and Eckerd Connects (collectively, the “Service Providers”)) to release/exchange any information that I have shared with Denver Workforce Services and/or the Service Providers with any educational, training, counseling, worksite, employer, social services, or criminal justice agency (collectively, the “Agency” or “Agencies”) for the purpose of assessment and enrollment into Denver workforce programs and/or ongoing support to reach my career, training, and/or educational goals. I also acknowledge that the identity of the Service Providers may change at the discretion of the City.
I authorize Denver Workforce Services and the Service Providers to release/exchange any information that I have shared with Denver Workforce Services and/or the Service Providers with other Agencies regarding any of the following: employment, unemployment, wage information, education and training, foster care, residence, health/mental health, family income, offender status and law enforcement/court records, extra-curricular activities, career plans and activities, and other government assistance. I understand that access to certain Denver workforce programs and services may be limited or denied without my consent to exchange information with other Agencies.
I have the right to inspect and copy the information released/exchanged from Denver Workforce Services and/or its Service Providers. I also understand that any information released/exchanged will be kept confidential in conformance with applicable law and will be used only to determine eligibility and appropriateness for Denver workforce programs and provide ongoing support to reach my stated goals.
This release will remain valid for one (1) year after the earlier of: 1) completion of services; or 2) the termination of my involvement with Denver Workforce Services. This authorization may be discontinued, by me, at any time with a written request submitted to Denver Workforce Services. I understand that any such revocation shall not affect disclosures previously made by Denver Workforce Services or the Service Providers.