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Missouri Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs)

State:
Missouri
Control #:
MO-SKU-0416
Format:
PDF
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Description

Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs) Missouri Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs) is a form used to grant permission for a treatment provider to release confidential information to another person or organization. This form is often used in situations where a person is receiving treatment for drug or alcohol abuse and needs to share the information with another party such as an employer, school, or court. The form must be completed and signed by the person receiving treatment, as well as a representative of the treatment provider. There are three types of Missouri Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs): Limited Release Authorization, Full Release Authorization, and Emergency Release Authorization. The Limited Release Authorization allows the release of only the information necessary to complete a specific purpose. The Full Release Authorization allows the release of all confidential information regarding the treatment program. The Emergency Release Authorization allows the release of confidential information in an emergency situation.

Missouri Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs) is a form used to grant permission for a treatment provider to release confidential information to another person or organization. This form is often used in situations where a person is receiving treatment for drug or alcohol abuse and needs to share the information with another party such as an employer, school, or court. The form must be completed and signed by the person receiving treatment, as well as a representative of the treatment provider. There are three types of Missouri Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs): Limited Release Authorization, Full Release Authorization, and Emergency Release Authorization. The Limited Release Authorization allows the release of only the information necessary to complete a specific purpose. The Full Release Authorization allows the release of all confidential information regarding the treatment program. The Emergency Release Authorization allows the release of confidential information in an emergency situation.

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Missouri Authorization to Release Confidential Information (Drug or Alcohol Abuse Programs)