Statement of Confidentiality

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Statement of Confidentiality

Our school is a vital part of the greater Tucson community. Respecting one’s privacy and confidentiality is very important. Each student with whom you observe has the right to expect that nothing that happens to or about him or her will be repeated to anyone other than authorized TCS employees.

Please check the boxes that apply to you and sign.

Email *

We, the family of (provide enrolled child(ren)'s name)______________________________, as participants at Tucson Community School may become privy to confidential information regarding children and families. *

It is of the utmost importance that we realize that all such information is strictly personal and confidential, and we agree to never disclose this information to anyone other than an authorized school employee. *

Yes

Information that needs to be shared with an authorized school employee will be relevant to the student’s educational growth, safety, or well being and will be shared out of hearing distance of the children. We will refer all requests for such information from those not directly involved in the student’s education to authorized school department employees. *

Yes

We understand that confidentiality is an ethical obligation and that it is a requirement for my continued involvement at Tucson Community School. By signing this statement, I understand and practice Tucson Community School’s confidentiality policy at all times. *

Yes

Do you give consent Tucson Community School, to use your name (as provided in the next question) as proof of your signature? *

Yes

Please type in your full name. This will be your electronic signature. *

Please provide the date you are signing this document. *

YYYY

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