CONFIDENTIALITY OF ALCOHOL & DRUG DEPENDENCE PATIENT RECORDS
42 CFR, PART 2
The confidentiality of alcohol and drug dependence patient records maintained by this practice/program is protected by federal law and regulations. Generally, SaVida Health and/or Agency may not disclose if someone is or is not part of SaVida Health and/or Agency, or disclose any information identifying a patient as being alcohol or drug dependent unless:
1. The patient consents in writing;
2. The disclosure is allowed by a court order; or
3. The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or practice/program evaluation.
4. All information identifying you as a substance user is confidential and may not be released without your written/signed consent. This federal regulation (42 CFR, Part 2) was created to decrease the stigma associated with substance use and to allow increased access to treatment.
Violation of the federal law and regulations by a practice/program is a crime. Suspected violations may be reported to appropriate authorities in accordance with federal regulations.
Federal law and regulations do not protect any information about a crime committed by a patient either at the practice/program, against any person who works for the practice/program, or about any threat to commit such a crime.
I acknowledge that I have been notified of my rights pertaining to the confidentiality of my treatment information/records under 42 CFR, Part 2; and I further acknowledge that I understand those rights.