Each person who is a client of the Timberlane Regional School District’s Student Assistance Program is assured legal rights and care consistent with basic human dignity.
Each client shall:
1. Have the right to receive services regardless of race, sex, creed, age, or sexual orientation.
2. Have the right to receive services within a reasonable amount of time.
3. Be assured that his/her confidentiality will be protected under Federal and State Confidentiality Regulations, which prohibit unauthorized disclosure of information.
4. Have the right to refuse services.
5. Have the right to be treated with respect.
6. Have the right to an impartial review of complaints. All complaints should be directed in writing to: Director of Secondary Education
Timberlane Regional School District
Chuck Coker
30 Greenough Road
Plaistow, NH 03865
AGGREEMENT FOR SERVICE:
I acknowledge that my rights have been fully explained to me.
I understand my rights as a client at the Timberlane Regional School District’s Student Assistance Program.
The Federal Law of Confidentiality has been explained to me and I understand its limitations (i.e., the threat of harm to self or others, child abuse or neglect, etc…).
Signature of Witness Date