Privacy policy
Information requested by CLEC will only be used to assist in the evaluation process of the applicant’s request to participate in the CLEC program. All information will be held confidential and will not be disclosed, other than in the administration of the individual’s acceptance and activities within the CLEC program, except by the written consent of the applicant, and, as applicable, his or her parent, guardian, or other person authorized to sign in lieu of the individual, or as otherwise required by law. If the information requested concerns drug or alcohol services, federal law forbids any use of this information to investigate or prosecute the individual.
This consent may be revoked at any time, except to the extent that the program that is to make the disclosure has already acted in reliance upon it. If not revoked, the consent will expire 12 months (60 days if the consent is for the release of medical records) from the date signed below, or upon a determination that the individual is ineligible or no longer eligible for the CLEC program.
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Contacts
PO Box 216
Crane, IN 47522
Toll Free: 877-528-2612
Fax: 812-863-2475