Form 032-02-0162-01-ENG Interagency Consent to Release Confidential Information for Alcohol or Drug Patients - Virginia

Form 032-02-0162-01-ENG Interagency Consent to Release Confidential Information for Alcohol or Drug Patients - Virginia

What Is Form 032-02-0162-01-ENG?

This is a legal form that was released by the Virginia Department of Social Services - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 032-02-0162-01-ENG?
A: Form 032-02-0162-01-ENG is the Interagency Consent to Release Confidential Information for Alcohol or Drug Patients form used in Virginia.

Q: What is the purpose of Form 032-02-0162-01-ENG?
A: The purpose of Form 032-02-0162-01-ENG is to obtain consent from alcohol or drug patients in Virginia to release their confidential information to interagency organizations.

Q: Who uses Form 032-02-0162-01-ENG?
A: Alcohol or drug patients in Virginia and interagency organizations use Form 032-02-0162-01-ENG.

Q: What information is released using this form?
A: This form is used to release confidential information related to an individual's alcohol or drug treatment, including diagnosis, treatment history, and other relevant information.

Q: Is the use of Form 032-02-0162-01-ENG mandatory?
A: The use of Form 032-02-0162-01-ENG may be required in certain situations where interagency organizations need access to an individual's confidential information for treatment or coordination purposes.

Q: Can Form 032-02-0162-01-ENG be used in states other than Virginia?
A: No, Form 032-02-0162-01-ENG is specific to Virginia and may not be applicable in other states.

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Form Details:

  • Released on November 1, 2009;
  • The latest edition provided by the Virginia Department of Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 032-02-0162-01-ENG by clicking the link below or browse more documents and templates provided by the Virginia Department of Social Services.

Download Form 032-02-0162-01-ENG Interagency Consent to Release Confidential Information for Alcohol or Drug Patients - Virginia

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  • Form 032-02-0162-01-ENG Interagency Consent to Release Confidential Information for Alcohol or Drug Patients - Virginia, Page 1
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