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Attached Document:
09-139-ope.pdf
Documents: 2009 Policy Bulletins
#09-139-OPE: Wellness, Comprehensive Assessment, Rehabilitation And Employment (WECARE) Medical Consent Form
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(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.
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Created: 7/5/2010
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