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I understand my student’s story and/or my story is ours to share. I understand Back2Back
Cincinnati will hold our information confidential unless necessary by law. I realize Back2Back
Cincinnati can better serve my student and/or our family when they communicate to other
individuals working with my student and/or our family. I give permission for Back2Back
Cincinnati to give and receive information in regards to my student(s) and/or myself from:
Hamilton County Public Defender’s Office, Hamilton County Prosecutor’s Office, Hamilton
County Job and Family Services, and Hamilton County Dependency Court.
I understand I can revoke this consent at any time by writing.
The Making Sense of Your Worth Curriculum follows a step-by-step process of gaining positive self-worth. It was created by Cindy R. Lee, LCSW in partnership with HALO Project International. This 8 week program will take place on June 8, 15, 22, 29 and July 6, 13, 20, and 27th during CBI programming.
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I understand my student’s story and/or my story is ours to share. I understand Back2Back Cincinnati will hold our information confidential unless necessary by law. I realize Back2Back Cincinnati can better serve my student and/or our family when they communicate to other individuals working with my student and/or our family. I give permission for Back2Back Cincinnati to give and receive information in regards to my student(s) and/or myself from Hamilton County Juvenile Detention Center (20/20), Hamilton County Juvenile Probation, Hamilton County Public Defender’s Office, Hamilton County Diversion Court Programs, Hamilton Prosecutor’s Office, and Hamilton County Juvenile Court.
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