Consent Management
Manage your 42 CFR Part 2 Substance Use Disorder confidentiality releases. Each recipient requires a separate, signed release group.
Create New Release
"The Signee authorizes the exchange of the below indicated information between Advance and the indicated party."
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Effective Date: 2026-05-06 |Expires on: ...
Required Signature
I understand that this release of information may include alcohol and/or drug treatment records that are protected under the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2) and the Health Insurance Portability and Accountability Act (45 CFR 160 & 164)and cannot be disclosed without my written consent unless otherwise provided for in the regulations.
I also understand that I may revoke this consent at any time except to the extent that action has already been taken in reliance on it. This consent expires automatically in one year if the participant is no longer receiving services. Otherwise, this release is valid until services with RNP have been completed.
I have been offered a copy of this form.
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