Consent
Description:
CONSENT FOR RELEASE OF INFORMATION
Source:
training.aaap.org
Description:
This patient consent form (in Word®) explains buprenorphine treatment and warns about the adverse effects of mixing buprenorphine with other medications. The section at the bottom is for the patient and a witness to sign and date, indicating that the patient understands and wishes to receive treatment.
Source:
California Society of Addiction Medicine (CSAM)
Tags:
Description:
The California Society of Addiction Medicine (CSAM) website provides information and materials for buprenorphine treatment providers, including screening tools and sample consent and patient agreement forms, and provides links to other helpful resources.
Source:
California Society of Addiction Medicine (CSAM)
Tags:
- General information - buprenorphine
- Getting a waiver/setting up your practice
- Initial patient contact
- Screening and diagnosis
- Rules, regulations and recordkeeping
- Physician and staff training
- Addiction
- Assessment
- Confidentiality
- Consent
- Contract
- COWS
- Recordkeeping
- Screening
- Training
- Waiver
- Misc. informational materials
- Becoming waivered
- Just became waivered
- Need to refer
- Setting up a practice
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)
Tags:
Description:
Analyzes the misconceptions that arise from the Health Insurance Portability and Accountability Act and discusses when health care providers should use their professional judgment in deciding whether a disclosure is necessary.
Source:
Journal of the American Medical Association (JAMA) 2005 Apr 13;293(14):1766-71. (3 votes)
Tags:
Description:
This series of tables provides state-by-state information about minors' rights regarding providing consent for substance abuse treatment.
Source:
Guttmacher Institute (3 votes)
Tags:
Description:
Patient contract that can be used to set expectations and guidelines before beginning buprenorphine treatment.
Source:
Substance Abuse and Mental Health Services Administration (SAMHSA) (3 votes)
Tags:
Description:
Patient contract that can be used to set expectations and guidelines before beginning buprenorphine treatment.
Source:
American Academy of Addiction Psychiatry (AAAP) (4 votes)
Tags:
- Initial patient contact
- Managing challenging patients
- Logistics of buprenorphine treatment
- Consent
- Contract
- Patient and physician communication
- What to expect during first treatment
- Physician and patient agreements
- Patient education materials
- Experienced prescriber
- Just became waivered
- Setting up a practice
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) (3 votes)
Tags:
Description:
Four-page document discussing treatment of pregnant patients with buprenorphine.
Source:
Physician Clinical Support System (PCSS) (3 votes)
Tags:
