Resource Center: Initial patient contact, Consent forms

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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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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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Consent Form for Buprenorphine Treatment during Pregnancy
Description: 
This consent form informs the patient of the limited amount of research and knowledge currently available regarding buprenorphine use during pregnancy, and acknowledges that risks related to such use may exist, but are not yet known.
Source: 
Colleen LaBelle, RN/Boston Medical Center
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Consent for Release of Information
Description: 
This form serves as a sample consent for release of the patient's information (type of information to be specified by the patient and/or doctor).
Source: 
American Academy of Addiction Psychiatry (AAAP)
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Your rating: None Average: 4.3 (3 votes)
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