Substance Abuse Treatment Admission Consent Form

Substance Abuse Treatment Admission Consent Form

Starting substance abuse treatment is a courageous step toward recovery, and having clear, organized consent documentation is essential for both patient safety and regulatory compliance. This Substance Abuse Treatment Admission Consent Form template helps addiction treatment centers, outpatient programs, and behavioral health facilities streamline their intake process while meeting strict confidentiality requirements under 42 CFR Part 2.

Why this form matters for substance abuse treatment providers

Substance abuse treatment requires specialized consent procedures that go beyond standard HIPAA authorizations. Federal regulations under 42 CFR Part 2 provide enhanced privacy protections for patients receiving treatment for substance use disorders, and non-compliance can result in serious penalties. This template addresses those specific requirements while also covering medication-assisted treatment (MAT) consent, program rules acknowledgment, and emergency contact information.

Whether you're running an outpatient clinic, residential treatment facility, or medication-assisted treatment program, this form helps you collect all necessary consents in one organized, professional document that patients can complete before their first appointment.

Built for healthcare providers who need compliant, efficient intake

This template is designed specifically for:

• Addiction treatment centers handling admissions for inpatient or outpatient substance abuse programs
• Behavioral health clinics offering MAT programs with buprenorphine, methadone, or naltrexone
• Mental health and substance abuse counselors requiring detailed consent before beginning treatment
• Hospital-based addiction medicine programs coordinating care across multiple providers
• Community health centers providing integrated substance use disorder services

The form captures treatment consent, medication preferences, confidentiality authorizations, emergency contacts, and program rules acknowledgment in a single workflow—reducing paperwork burden while ensuring you have everything documented from day one.

Automate what happens after admission with Stepper

Once a patient submits their consent form, Stepper can automatically trigger your entire intake workflow. Create their patient record in your EHR, notify the care team, schedule their first appointment, send welcome materials, and route any required medical clearances—all without manual data entry. This means your clinical staff can focus on patient care while the administrative side runs smoothly in the background.

If you need signed acknowledgment of program rules or medication consent, you can also use Papersign to turn form responses into formal eSignature documents that are securely stored and linked to each patient's record.

Why Paperform for substance abuse treatment intake

Paperform is trusted by healthcare providers who need HIPAA-compliant forms that are also easy to use and professional-looking. This template uses conditional logic to show medication-assisted treatment options only when relevant, protects sensitive data with SOC 2 Type II compliance, and integrates with your existing EHR or practice management system through native connections or Stepper workflows.

With Paperform, you get a substance abuse treatment consent form that meets federal confidentiality requirements, provides a respectful patient experience, and connects seamlessly to the rest of your care delivery process—all without writing a single line of code.