The DA Form 5018 R, formally titled ADAPCP Client Consent Statement for Release of Treatment Information, protects the privacy of individuals enrolled in the Army's Alcohol and Drug Abuse Prevention and Control Program.
The form is divided into three sections. Section A captures the client's voluntary consent to disclose specific information, including diagnosis, prognosis, or treatment details, to named recipients. Section B defines when the consent expires and how the client may revoke it before that date. Clients involved with civilian criminal justice officials receive added protections under this section.
Section C establishes the approval authority. An authorized official must confirm that releasing the information does not harm the client before any disclosure occurs. This safeguard reflects the Army's commitment to client well-being and ethical healthcare practices.
| Question | Answer |
|---|---|
| Form Name | DA Form 5018-R |
| Form Length | 1 pages |
| Fillable? | Yes |
| Fillable fields | 1 |
| Avg. time to fill out | 27 sec |
| Other names | da 5018 r fillable, da form 5018 r pdf, form adapcp form, da form 5018 r fillable |