Terms & Conditions:
I understand that I am applying for, or may be receiving services from, Rebuilding Together® Howard County, Inc. In order to access additional services for which I may be eligible, I grant permission for Rebuilding Together® Howard County, Inc. to share referral information with the agencies listed below, unless stricken through. My confidentiality will be protected by these agencies while permitting the flow of appropriate information among the staff of agencies listed above. I understand that to the extent permitted by law, my records will be treated confidentially. I understand this consent may be revoked by me at any time. Howard County Office on Aging, Howard County Disability Services, Howard County Dept of Social Services, Howard County Consumer Affairs, Howard County Health Department, Howard County Department of Housing, Howard County Office of Children’s Services, Neighbor Ride, Howard County Community Action Counsel. Rebuilding Together also works with congregations that may provide emergency or minor repair work. By checking the box below, I authorize RTHC to contact these congregations on my behalf if the repairs I have requested are more appropriate to the services they offer.