Patient Resources

Consent to Release Form

Please review and sign this form to authorize C.O.R.E. Medical Clinic to release or share your information with the person or organization you designate. This form explains what information may be shared, the purpose of the disclosure, and your rights regarding this authorization.

Emergency Contact Release of Information Form

Please review and sign this form to authorize C.O.R.E. Medical Clinic to communicate with your designated emergency contact when appropriate. This form explains what information may be shared, with whom it may be shared, and your rights regarding this authorization.

Informed Consent for Treatment with Buprenorphine Form

Please review and sign this form to confirm that you understand and consent to treatment with buprenorphine. This form explains important information about the treatment, including its purpose, potential benefits, risks, responsibilities, and other considerations you should understand before beginning treatment.

Pre-admission Screening Sheet

Collects essential patient information before admission to help C.O.R.E. Medical Clinic assess eligibility, treatment needs, and readiness for services.

SMS Consent Form

Please review and sign this form to authorize C.O.R.E. Medical Clinic to send you text messages related to your care, including appointment reminders, treatment updates, clinic notifications, and other important communications. You may opt out of text messaging at any time.