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924 Chapter 5:Temporary Assistance for Domestic Violence Survivors (TA-DVS) Program • Section 9: Co-located domestic violence advocates (07/2026) individual wishes. c. Obtains verbal authorization by stating the following to the individual and receiving confirmation: “By verbally signing this release of information form, you agree that you are choosing to give me permission to share ____ (specific information) with ____ (community agency) for ___ (time period). If you do not want me to share that information, you can withdraw your consent now or at any time in the future. Would you like to verbally sign this release of information form? If ‘yes,’ please state your first and last name.” d. Document on the signature line of the MSC 3010, “Verbal authorization received by phone on (date).” Case notes in ONE that MSC 3010 was verbally authorized and uploaded to the electronic case file. 5. ODHS staff shares only the information stated in the MSC 3010 with the named community agency. Considerations for ROIs and informed consent relating to DV: • Informed consent must be a part of filling out an MSC 3010 with an individual. It is particularly important when sharing DV information or information from which DV can be inferred because it supports safety, empowers the individual, and builds trust. • Informed consent • Ensures the individual has real choice over what is shared and how • Ensures the individual fully understands their options and any risks • Clarifies that the individual does not have to sign an MSC 3010 • Includes a limited timeframe determined by the individual (no more than 90 days for a hardcopy signature and no more than 30 days for verbal authorization) • Every conversation is to begin with a blank MSC 3010. ODHS staff should not fill out any part of an MSC 3010 before beginning the conversation with an individual. It should not be assumed that every individual will want to sign an MSC 3010. • Consent is a process that can change over time. It is best practice to review a completed MSC 3010 with an individual at different times so they are reminded they have the option to change or withdraw consent. • Each MSC 3010 is for one recipient agency. A precise MSC 3010 gives an individual more control over their information. • Give individuals plenty of time to think through the risks and decide if they want to sign an MSC 3010. Remember that crisis can make processing or giving linear information difficult. • It is best practice to use language like: • “Would you like to talk about signing a release?” • “You do not have to sign a release to get services.” • “If you would like, I can explain the options for getting your permission to share this information, and you can let me know if any of these options work for you. What do you think?” • Avoid using language like: • “I need a release.”