Our organization's policy includes the belief that all individuals who seek services from Catholic Charities of
Dallas have certain rights that will be protected in all policies and procedures. We reserve the right to
determine who we believe we can serve appropriately, within the limits of our mission, capacities, and
resources.
You have the right:
1. To a copy of the client rights and responsibilities explained to you as part of the intake or admission
process, and to have it explained in a language that you understand;
. To be treated with respect, dignity and professionalism and receive services free from physical, mental
or sexual abuse;
3. To receive service based on need and eligibility and not be denied services based on race, color, gender, gender
identity, sexual orientation, national origin, age, marital status, religion or disability ;*
4. To receive services by a qualified program employee that includes an individualized, written service
plan, if appropriate, which is reviewed periodically, updated as necessary, and signed by you and the
employee;
5. To be informed of the service procedures, anticipated length of service period, and scope of service.
6. To review a written fee schedule, if applicable, to receive an explanation of your bill for service upon
request regardless of source of payment and consequences of nonpayment;
7. To not be deprived of any rights, privileges or benefits which are guaranteed to individuals by the state
or federal constitution;
8. To make a complaint, grievance or suggest changes in service program policies and procedures to an
employee, supervisor, director or the Texas Health and Human Services Commission 1-877- 787-8999
or the Texas Department of State Health Services 1-888-963-7111;
To be informed of your case termination and any further requirements related to the successful
termination of your case;
10. To request in writing to review, copy and/or receive a summary of your records in the service program
office in the presence of the caseworker or employee assigned to your case; A review may be denied
or limited where confidentiality could be compromise, or in accordance with applicable law(s).
11. To comment on the accuracy of the record and to insert your own statements; an employee may
comment or respond to your statements during review, if applicable.
12. To have your records secured against unauthorized access; to have any release of information
protected by Catholic Charities of Dallas according to all applicable laws and regulations;
13. To know that any release of identifiable information will be with your written consent (except when you
are a danger to yourself or society); Such consent will include: the specific information to be given, the
time period in which this information remains in effect, to whom the information is to be given, and for
what purpose it is to be given
14. To receive an explanation of any proposed experiment or research procedures and to refuse
participation in the experiment or research without jeopardizing your continuing services; and
15. To protect your right to privacy in all public relations activities on behalf of Catholic Charities of Dallas.
16. To receive services that afford safety, privacy and a smoke free environment.
Your responsibilities are:
1. To attend and fully participate in services involving your service plan;
2. To provide accurate and necessary information to Catholic Charities of Dallas and to report all changes
of circumstances that affect your case or eligibility;
3. To treat the caseworker or other persons who serve you with respect; physical threats or verbal abuse
is not tolerated; and,
4. To make payment(s) for service as outlined in the fee schedule, if appropriate, in a timely manner.
By my acceptance, I acknowledge that I have read and understand my rights and responsibilities.
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