820 Crater Lake Ave #202
Medford, OR 97504
Tel: 541.779.2273
Fax: 541.779.6412




 Our agency is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations.  Your “personal financial information’, such as your total debt information, income, living expenses and personal information concerning your financial circumstances, will be provided to creditors and, possibly others with your specific authorization.  We may also use aggregated case file information for the purpose of evaluating our services, gathering valuable research information and designing future programs.  Your anonymity will be maintained through the use of your client number or by using aggregate data in all circumstances.
In all situations, your information may be released to appropriate individuals or agencies ONLY UPON YOUR WRITTEN REQUEST OR when our staff has been served by a valid subpoena.
The following PRIVACY PRACTICES detail circumstances under which we will release your information to a third party:
  1. We do not disclose any non-public personal information about our clients or former clients to anyone, except as permitted by law.
  1. We may compile data and aggregate information that you give to us, but this information may not be disclosed in a manner that would personally identify you in any way.
  1. We may disclose some or all of the information that we collect, as described below, to creditors, or third parties that you have authorized who need this information in order for us to assist you after a counseling session.
  1. We may disclose all of the information that we collect, as described below, to creditors and related financial institutions that need this information and that you have authorized in order to put you on a debt management program (DMP).
  1. We restrict access to non-public personal information about you to those employees who need to know that information to provide services to you.  We maintain physical, electronic and procedural safeguards that comply with federal regulations to store and guard your non-public personal information.
  1. We collect non-public personal information about you from the following sources:
    • Information we received from you on our applications or other forms you provide;
    • Information about your transactions with us, your creditors, or others; and
    • Information we receive from a credit reporting agency.

Release:  I hereby authorize CCCS of Southern Oregon to release all non-public information it obtains about me to my creditors and any third parties necessary to resolve the matter(s) discussed during my counseling session.  I further release and authorize all of my creditors to provide non-public information about me to CCCS of Southern Oregon.