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HIPAA / Health information: I authorize the program, when supported by signed consent and allowed by law, to communicate with my identified medical or behavioral health providers for service coordination.

General release of information: I authorize True Reflections Community Development, Inc. and its fiscal sponsor Faith & Grace Future Leaders, Inc. to exchange relevant information with referral agencies, service providers, employers, educational partners, landlords, and other approved partners for eligibility review, service coordination, and case planning.

Background check: I understand the program may complete legally permitted background screening as part of placement and safety review.

Photo release: initial to confirm your choice above.

Emergency medical: I authorize staff to seek emergency medical care on my behalf if I am unable to consent and immediate care is needed.

Transportation: I understand transportation may be provided or coordinated for approved program-related purposes.

Resident agreement: I understand participation requires honesty, cooperation, and active engagement in case planning.

House rules: I agree to follow house rules, safety standards, and shared-living expectations.

Drug-free policy: I understand the program maintains a drug-free environment and violations may result in disciplinary action or discharge.

Curfew policy: I agree to follow curfew and sign-in/sign-out procedures unless otherwise approved.

Visitor policy: I understand visitors are subject to program rules and unauthorized guests may not be allowed.

Community standards: I agree to treat all residents, staff, and visitors with dignity and respect.

Non-traditional housing: I understand housing may be shared, communal, or transitional in nature.

Program fee: If a program fee applies, I understand payment expectations will be explained to me.

Deposit: If a deposit applies, I understand the terms for payment and refund or forfeiture.

Property care: I agree to maintain my assigned area and report damage or safety concerns.

Grievance procedure: I understand I may raise concerns through the program grievance process without retaliation.

Termination policy: I understand serious or repeated violations may result in discharge.

Participant responsibilities: I will participate honestly and tell staff about changes in my circumstances.

Participant rights: I understand I have rights to dignity, privacy within legal limits, fair review, and reasonable accommodation.