Research • Policy • Practice

Topic: Consent

Valencia County DWI Drug Court Consent Form

This document is a consent form to disclose medical information of DWI participants to specific treatment providers.

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Teton County DUI/Drug Court Authorization for Release of Confidential Information

This Authorization for Relase of Confidential Information form was provided by the Teton County DUI/Drug Court in Teton County, WY.

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Luzerne Consent Form

This consent form is used to allow the Luzerne County Treatment Court to retain information regarding a participant’s case following expungement of his/her charges if granted.

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Teton County DUI/Drug Court Program Understanding and Agreement

This is an agreement for Teton County’s DUI/Drug Courts that provides a list of conditions that must be agreed upon prior to starting the program.

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Rockland County Drug Court Consent for Disclosure of Confidential Information

This consent form is used by the Rockland County Drug Court program for the release of medical information to the court.

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Informed Consent for Acupuncture Treatment

INFORMED CONSENT FOR ACUPUNCTURE TREATMENT. I voluntarily consent to receive acupuncture treatment provided by a California licensed acupuncturist employed with the Community Acupuncture Recovery Association (C.A.R.A).

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Caroline County Adult Drug Court Consent for the Release of Confidential Information

This consent form is used to disclose personal information from the program to the court for Caroline County Adult Drug Court program.

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Multnomah County DUII Intensive Supervision Voluntary Admission Request

This voluntary entrance request is used for individuals who are interested in participating in the Multnomah County DUII Intensive Supervision program.

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