Research • Policy • Practice
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Sample Form: Confidentiality

York County Treatment Court Policy on Confidentiality

This document provides information on the York County Treatment Court Confidentiality policy.

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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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Rapides Parish Drug Court Statement of Confidentiality

This document provides an overview of keeping client information confidential for the Rapides Parish Drug Court program.

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Henry County Resource Court Confidentiality Statement

This is a confidentiality statement that must be signed by staff of the Henry County Resource Court 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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Confidential Information Release Authorization, F-82009

This is a Confidential Information Release Authorization Form (F-82009) simply allowing the persons whose records are released may have the right to inspect and obtain their records.

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Dakota County Confidentiality Agreement

The confidentiality agreement presented by Dakota County, Minnesota is a set of rules and guidelines that one must follow to take make sure private information will not be distributed to the wrong individuals.

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Cherokee County Drug Court Program Confidentiality Agreement

This is a confidentiality agreement from Cherokee County that the participant must sign in regards to medical records.

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Authorization to Disclose Claimant/Benefit and Protected Health Information

Authorization form for the Hennepin County Veterans Treatment Court for the participant to disclose protected health information for the program.

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