Purpose of the Client Revocation of Consent Form

Clients may, but are not required to, share their personal information with different agencies by signing the Release of Information (RoI), also known as the HMIS Privacy Notice and Client Consent FormBy agreeing to share their Personal Identifiable Information (PII), agencies can search for existing client profiles within Clarity.

Clients may choose to no longer share their PII or rescind a previously signed RoI at any time.  This process can be completed by signing the HMIS Revocation of Consent Form and contacting HMIS Support to ensure client privacy profile settings in Clarity are changed. There is no penalty, and no client can be refused services by the CoC for declining or revoking the RoI. 

Process of Revoking Consent

  • Signing a Hard Copy
  • Signing Electronically
  • Canceling Permission in Clarity

Signing a Hard Copy

If a client decides to stop sharing personal information, the agency presents the Revocation of Consent Form to the client.  The hard copy must be kept securely onsite as well as scanned and uploaded as a file in Clarity.  The directions for attaching a file to a client profile are outlined below.

Attaching Files in Clarity

1. Scan the hard copy document and save it to a file in your computer.

2. In Clarity, click on the "Files" tab from the client profile page. 

3. Click "Add File". 

4. Choose the appropriate category for the document. 

5. Choose the appropriate name.

6. Click "Select File" and choose the file saved to your computer. Then click "Save Changes". 

Signing Electronically

HMIS users have the option of having the client sign the Revocation Form electronically, just as they can the HMIS Privacy Notice and Client Consent Form. It's located within Client Programs.

1. From the client profile page, click on "Programs," then click the edit button on the applicable program.

2. Click on "Forms."

3. Click "Add Form."

4. Highlight "HMIS Client Revocation of Consent Form" and click "Add." If you are adding a scanned version of the form, click "Upload scanned version of form" which will take you to the "Select File" option noted above. 

5. The signature screen appears, and the client can sign by mouse, finger, or stylus, depending on circumstances. Click "Apply," then "Save" to complete. 

Cancelling Permission in Clarity

Once the client has signed the Revocation Form, it's still necessary to cancel the client's Release of Information from Clarity. Note: This is not deleting the client's original permission form from the system. You'll keep the original information for record keeping purposes, it just will no longer be valid. 

1. Open the client's profile. Click on the "Shield" icon. This opens the privacy page. 

2. Click the "Edit" button next to the Release of Information (RoI) you want to cancel. 

3. Change the "End Date" to today's date. Click "Save Changes". 

See the top of the page. If you see a green bar, your changes have been saved successfully. A red bar means the changes were not saved. Make any corrections, then save again. 

Note: The revocation form is not retroactive. Any information that has previously been shared by the agency because the client signed the consent form is not unshared by the revocation form.

Contact Information

If you need help, or wish to offer suggestions or feedback, please contact the Cincinnati/Hamilton County CoC HMIS Support Team at HMISsupport@end-homelessness.org or by calling 513-263-2790 9:00 am - 3:00 pm Monday through Friday excluding holidays. 

When contacting HMIS Support, please do not include any Personal Identifiable Information such as social security numbers, birth dates, etc. Acceptable information is the Clarity Unique Identifier found on the Clarity client's profile page.