ES-005 RETAIN Informed Consent and Privacy Form | RETAINWORKS

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ES-005 RETAIN Informed Consent and Privacy Form

File size: 126.00 KB

Created: 01-09-2022

Updated: 01-09-2022

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1000 SW Jackson, Suite 100 Topeka, KS 66612

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(316) 771-6851

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retainworks@ks.gov

About Us

RETAINWORKS is a free, grant-funded program focused on helping people whose lives have recently been disrupted because of an injury, illness, or worsening health problem.

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Workforce Alliance of South Central Kansas
Ascension Via Christi
Kansas Department of Commerce
The University of Kansas Health System
Stormont Vail Health
WorkforceONE
Heartland Works, Inc.
Workforce Partnership
RETAINWORKS

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RETAINWORKS is funded by the U.S. Department of Labor and the Social Security Administration under a grant award of $21,600,000 to the Kansas Department of Commerce that will be incrementally provided. 100% of grant funding is from U.S. Federal funds. This website does not necessarily reflect the views or policies of the U.S. Department of Labor or the Social Security Administration, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Equal Opportunity Employer/Program – Auxiliary aids and services are available upon request to individuals with disabilities. Any individual with a disability may request accommodations by contacting the Program Manager at (316) 771-6851, TDD: 711 or 1-800-766-3777, retainworks@ks.gov.

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