Sample Form: Consent Forms

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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Program Overview – Orientation & Decision

This is a form given to potential participants in Butler County’s Veterans Court to sign and submit if they wish to apply for Veterans Court or decline the application to Veterans Court. 

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Consent to Release Information Concerning Chemical Dependence Treatment

This is a consent form from the Buffalo Veterans Treatment Court to release participant information about chemical dependence treatment.

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Delta County Family Dependency Treatment Court Consent to Release Information

This consent is signed by the parents to release information to the Delta Family Dependency Treatment Court.

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OASAS Consent Form to Release of Information Concerning Chemical Dependence Treatment

This consent form delineates the conditions and scope of releasing confidential information of the participant to the treatment parties involved in his/her recovery. 

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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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Madison County Problem Solving Courts Confidentiality Contracts

This is an example form used by the Madison County Problem Solving Courts to obtain consent for release of participants’ confidential information.

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Cherokee County Drug Court Consent Form

This is the Cherokee County Drug Court Consent for Release of Confidential Information in Criminal Proceedings.

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Las Vegas Drug Court Authorization for the Release of Record Information Form

This is a sample form for the authorization for the release of record information for the Las Vega Justice Court Department 8 Drug Court.
Topics: Participants

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Sacramento County Drug Court Consent for the Release of Confidential Information

This consent form is to be signed by participants of the Sacramento County Drug Court program.

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