CASA Advocate Confidentiality Statement Name* First Last Email* Your Supervisors Email* Docket Number* Case Name* Date of Appointment* MM slash DD slash YYYY Confidentiality Oath Signature* All information I receive will be held in the strictest confidence. When my case is closed, I will return any and all information I obtained during the life of the case to my CASA Advocate Supervisor. If for any reason I can no longer fulfill my responsibilities as the Guardian Ad Litem for the case, I will immediately return any and all information I obtained during the case to my Advocate Supervisor.Consent* I agree to the use of an Electronic signatureBy electronically signing this agreement, I hereby accept appointment as volunteer court appointed special advocate in the above entitled matter. I have access to the case records through the CASA of Galveston Optima database system and further understand that I will receive additional case record information, both written and verbal as it becomes available. I understand that we have sworn to maintain confidentiality of all information that we receive. I will maintain confidentiality of these case records by: · Keeping all written records in a secure place while in my possession, · Not discussing the case with anyone other than parties to the lawsuit and my CASA supervisory staff, · Following all CASA of Galveston County procedures regarding which records I may keep in my possession and which must remain in the CASA office, · Returning any written case records to the CASA office within 10 days, either when my case closes, or at such time I resign from the case. If at any time I feel unable to carry out the duties and obligations assigned, I will immediately consult with the Executive Director. I have been informed of the Texas Human Resources Code (40.005) which provides that, a person who is authorized to receive confidential information shall maintain its confidentiality and shall prevent disclosure of the information to a person who is not authorized to receive the information. It is a Class A misdemeanor to disclose, without authorization, confidential information contained in the Texas Department of Protective and Regulatory Services records, papers, files, or communications.Date Signed* MM slash DD slash YYYY Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related