Consent Tracking for Admins in Avatar

ROI

• ROI Exchange, Disclose, Information & Release Medical Records-Use or Disclosure of Protected Health Information
• Client Access to Chart (PHI): EnglishSpanishTagalog
• Client Request to Amend Medical Record (PHI)
• Client Request to Restrict Use or Disclosure of Protected Health Information (PHI)
• Media Release Form (SMC Employee, Contractor, Client or Volunteer)
• Staff Request to Block BHRS Electronic Medical Record

Medication

• Medication Consents
• JV 220

Treatment Related

• Treatment Consent with Receipt Notice of Privacy Practices
• Senior Peer Counselor:EnglishSpanish
• Session Recording and/or 1-Way Mirror Observation: EnglishSpanish
• Student Observation at Behavioral Health Clinic
• Therapeutic Day School Medication Supervision Consent Form
• Urine Toxicology Screening Agreement
• Youth Emergency/Medication Consent Release Form