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1 verbatim requirement extracted from media-10335__Drug-Court_Participant-Release-of-Information-for-19th-Judicial-Circuit_V.2_KEB.pdf, across 1 topic.
Nineteenth Judicial Circuit (Indian River, Martin, Okeechobee, St. Lucie). Check the order's own effective and rescission dates before relying on it. Procedural information only; not legal advice.
EXHIBITS & EVIDENCE • AUTHORIZATION FOR RELEASE, DISCLOSURE, AND TRANSMISSION OF CONFIDENTIAL INFORMATION I, ______________________________, as a participant in the Problem -Solving Court Program, acknowledge that my treatment information is confidential under federal law. Disclosure of this information is governed by Part 2 of Title 42 of the Code of Federal Regulations (CFR), which protects substance use disorder patient records, and Part 164 of Title 45 of the CFR (HIPAA), which governs the security and confidentiality of health records. I understand that unauthorized disclosure is unlawful but that I may voluntarily consent to the release of my information. Consent for Disclosure I, ______________________________, consent to the release of employment, medical, psychiatric, treatment, educational, mental health, and other records necessary for Problem - Solving Court proceedings related to case number(s): ___________________________________________. I also authorize the disclosure of ongoing communications regarding my diagnosis, prognosis, and compliance, including but not limited to: • Assessment results relevant to eligibility, treatment needs, and supervision; • Attendance at scheduled appointments; • Drug and alcohol test results, including attempts to defraud tests; • Progress toward treatment plan goals; • Evidence of symptom resolution and attitudinal improvements; • Compliance with court program requirements, including employment and education; • Adherence to electronic monitoring, curfews, travel, and association restrictions; • Use of authorized medically assisted treatments; • Unauthorized prescriptions for addictive substances; • New arrests or offenses; and • Threatening or disruptive behavior.
AUTHORIZATION FOR RELEASE, DISCLOSURE, AND TRANSMISSION OF CONFIDENTIAL INFORMATION I, ______________________________, as a participant in the Problem -Solving Court Program, acknowledge that my treatment information is confidential under federal law. Disclosure of this information is governed by Part 2 of Title 42 of the Code of Federal R egulations (CFR), which protects substance use disorder patient records, and Part 164 of Title 45 of the CFR (HIPAA), which governs the security and confidentiality of health records. I understand that unauthorized disclosure is unlawful but that I may voluntarily consent to the release of my information. Consent for Disclosure I, ______________________________, consent to the release of employment, medical, psychiatric, treatment, educational, mental health, and other records necessary for Problem - Solving Court proceedings related to case number(s):
Reviewer note: Document sha256: e1ddbcdf334937c818bd666491e5c16fd04e2b378edeeb667399a6d7c25388a0. One rule per order rather than per topic, so an order's requirements stay together. Published during the completeness pass. | Title normalised 2026-07-26 for readability; the court's own asset name was "19th Cir. — media-10335__Drug-Court_Participant-Release-of-Information-for-19th-Judicial-Circuit_V.2_KEB.pdf: published requirements". Only the display title changed — the requirement text, source URL and hash are untouched. Text layer cleaned 2026-09-08 (Phase 3g): 1 kerning-split word rejoined; wording untouched. Verbatim from the order, captured 2026-07-24; whitespace normalised only. No OCR was used anywhere in this chain. [moved from the text 2026-09-14]
1 verbatim requirement on exhibits in BETSY BENSON's division.
4 verbatim requirements on exhibits & evidence.
1 verbatim requirement on exhibits & evidence.