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Office of Addiction Services and Supports

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24/7 HOPEline: Call 1-877-8-HOPENY | Text 467369.


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241 results found available within Consent and Authorization (TRS) Clear All
Consent and Authorization (TRS)
Consent for Fingerprinting and Criminal Background Check (TRS-52)

Spanish. Required as part of the criminal background check process of all prospective employees in OASAS-certified facilities.

  • Download about Consent for Fingerprinting and Criminal Background Check (TRS-52)
Consent and Authorization (TRS)
Request to Review Denial ( (TRS-36)

Bengali. Used by patients to request a review of denied requests to amend/restrict the disclosure of confidential information.

  • Download about Request to Review Denial ( (TRS-36)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Traditional Chinese. To be used by patients who wish to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Spanish. To be used by patients who wish to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Russian. To be used by patients who wish to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Korean. To be used by patients who wish to to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Italian. To be used by patients who wish to to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Haitian Creole. To be used by patients who wish to to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Restrict Use (TRS-35)

Bengali. To be used by patients who wish to to restrict the disclosure of their confidential information.

  • Download about Request to Restrict Use (TRS-35)
Consent and Authorization (TRS)
Request to Review Denial ( (TRS-36)

Traditional Chinese. Used by patients to request a review of denied requests to amend/restrict the disclosure of confidential information.

  • Download about Request to Review Denial ( (TRS-36)

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