Online Resource Center


Fair Hearings
OTDA Policy
Language Resources
  NYC HRA Directives:  Not Logged in     
Search Keywords or type in your question (min 3 char.)
PB Home  Back to Documents: 2009 Policy Bulletins    
Attached Document:

Documents: 2009 Policy Bulletins

#09-139-OPE: Wellness, Comprehensive Assessment, Rehabilitation And Employment (WECARE) Medical Consent Form
(This Policy Bulletin Revises PB #07-116-SYS)
The purpose of this policy bulletin is to inform Job Center staff that:
• The Consent for the Disclosure of Medical, Alcohol and Substance Abuse Treatment Records form (M-76N) and the Consent for Release of HIV and Related Information form M-76M) have been made obsolete and a new medical consent form will replace the two obsolete consent forms.
• The new Customized Assistance Services (CAS), HIPPA* Compliant Authorization for Disclosure of Individually Identifiable Information, Drug Treatment Records and Confidential HIV** Related Information form (HRA-W-333T) must now be used for individuals being referred to WeCARE.


Created: 7/5/2010