DA Form 5018-R. Adapcp Client`s Consent Statement for Release of Treatment Information (LRA)

Form DA 5018-R is an Adapcp Client's Consent Statement for Release of Treatment Information (LRA). This form is used in the Army Substance Abuse Program to obtain the consent of clients for the release of information related to their treatment and progress in the program.

The form consists of sections where the client provides their consent for the release of treatment information to specified individuals or entities. The form may also include sections for documenting the purpose of the release and the specific information to be disclosed.

Important fields in this form include accurate and specific information about the client's consent, the purpose of the information release, and the individuals or entities authorized to receive the information. Obtaining informed consent is crucial to maintain the confidentiality and privacy of the client's treatment information.

Application Example: A client in the Army Substance Abuse Program wishes to share their progress and treatment information with their primary healthcare provider. The program uses Form DA 5018-R to obtain the client's consent for the release of specific treatment information to the designated healthcare provider.

Related Forms: There may be other forms used for obtaining consent for the release of medical or treatment information in various healthcare and treatment programs.