Resource Center: Rules, regulations and recordkeeping, Consent forms

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Consent to Release of Information Under Title 42, Part 2, Code of Federal Regulations
Description: 
An example of the wording and structure necessary in a consent for release of information form.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Patient Handout: Confidentiality and Consent

Description: 
This is a patient handout to inform patients about their rights when undergoing office-based buprenorphine treatment.

Patient Rights: Confidentiality and Consent

As a patient getting treatment for a substance use disorder, your personal and medical

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Minors' Right to Consent to Health Care and to Make Other Important Decisions
Description: 
This series of tables provides state-by-state information about minors' rights regarding providing consent for substance abuse treatment.
Source: 
Guttmacher Institute
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Sample Consent Form

Description: 
This is a sample of a consent form that can be used when initiating buprenorphine treatment for a new patient.

BUPRENORPHINE MAINTENANCE TREATMENT

Sample #1 --Patient information and consent to treatment with buprenorphine

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Sample Confidentiality and Consent Forms
Description: 
This appendix from TAP 13: Confidentiality of Patient Records for Alcohol and Other Drug Treatment provides sample consent forms for substance abuse patients.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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