When cleared for an approach and not on vectors, is a depicted course reversal always required?
Yes, with this procedure you are required to fly the procedure turn unless you are flying the CVV transition (which is notated as NoPT), are receiving vectors to final, or receive a clearance for a "straight-in approach" over EYWOK.  If you are cleared direct to the final approach fix, none of these apply (but remember that you can always request a straight-in approach if you don't want to do the course reversal)!

FAR 91.175


  (j) Limitation on procedure turns. In the case of a radar vector to a
  final approach course or fix, a timed approach from a holding fix, or
  an approach for which the procedure specifies "No PT," no pilot may
  make a procedure turn unless cleared to do so by ATC.


The AIM states:


  5-4-6. Approach Clearance
  
  4. If proceeding to an IAF with a published course reversal (procedure turn or hold­in­lieu of PT pattern), except when cleared for a
  straight in approach by ATC, the pilot must execute the procedure
  turn/hold­in­lieu of PT, and complete the approach.
  
  5. If cleared to an IAF/IF via a NoPT route, or no procedure turn/hold­in­lieu of PT is published, continue with the published
  approach.
  
  6. In addition to the above, RNAV aircraft may be issued a clearance direct to the IAF/IF at intercept angles not greater than 90 degrees
  for both conventional and RNAV instrument approaches. Controllers may
  issue a heading or a course direct to a fix between the IF and FAF at
  intercept angles not greater than 30 degrees for both conventional and
  RNAV instrument approaches. In all cases, controllers will assign
  altitudes that ensure obstacle clearance and will permit a normal
  descent to the FAF. When clearing aircraft direct to the IF, ATC will
  radar monitor the aircraft until the IF and will advise the pilot to
  expect clearance direct to the IF at least 5 miles from the fix. ATC
  must issue a straight­in approach clearance when clearing an aircraft
  direct to an IAF/IF with a procedure turn or hold-in-lieu of a
  procedure turn, and ATC does not want the aircraft to execute the
  course reversal.
  
  7. RNAV aircraft may be issued a clearance direct to the FAF that is also charted as an IAF, in which case the pilot is expected to execute
  the depicted procedure turn or hold­in­lieu of procedure turn.  ATC
  will not issue a straight­in approach clearance.  If the pilot desires
  a straight­in approach, they must request vectors to the final
  approach course outside of the FAF or fly a published “NoPT” route. 
  When visual approaches are in use, ATC may clear an aircraft direct to
  the FAF.