Below is a copy of our Privacy Agreement:  Please read it, sign it and fax or mail it back with your Intake Form.)
 
 

 PRIVACY AGREEMENT

Before you begin your work with the Dispute Resolution Department, you should understand that any and all conversations or anything that transpires in the course of your work will be kept strictly confidential by Dispute Resolution employees.  The contents of your work will not be discussed with anyone without your oral or written permission.

The only exceptions to the above agreement occur in the following circumstances:

1. If there is reason to believe that an individual's safety, health and/or welfare would be harmed by a failure to disclose otherwise confidential information to appropriate officials;

2. If the allegations involve Civil Rights issues, relevant information will be released to the University's Office of Equal Opportunity;

3. If information about criminal behavior is revealed;

4. If it becomes necessary to defend a claim against the Dispute Resolution Department; and/or

5. If, after opposing efforts by other parties to obtain this information, we are ordered by a court to release such information.

You should understand that with the above exceptions, the contents of your interactions with all employees of the Dispute Resolution Department are private and that none of the information discussed in the course of this work may be disclosed to others.  You agree not to call Dispute Resolution staff as witnesses in any judicial or administrative proceedings except for the purpose of testifying as to the number of meetings which occurred.

By mutual agreement, no audio or video tapes will be taken of any meetings without the consent of all parties.  In addition, whatever the outcome of your work at DR all documentation will be destroyed with the exception of the DR Privacy Agreement, contact and release logs, and the initial intake form.
 

___________________________________  ___________________________________
                        Employee           Date
 

___________________________________              _________________________________
                        Witness            Date