Form 4009 Informed Consent for Pregnant Opioid / Opiate Use Disorder Individuals Seeking Treatment - Texas

Form 4009 Informed Consent for Pregnant Opioid / Opiate Use Disorder Individuals Seeking Treatment - Texas

What Is Form 4009?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 4009?
A: Form 4009 is the Informed Consent for Pregnant Opioid/Opiate Use Disorder Individuals Seeking Treatment in Texas.

Q: Who needs to fill out Form 4009?
A: Pregnant individuals with opioid/opiate use disorder who are seeking treatment in Texas need to fill out Form 4009.

Q: What is the purpose of Form 4009?
A: The purpose of Form 4009 is to provide informed consent for pregnant individuals with opioid/opiate use disorder to receive treatment in Texas.

Q: Are there any specific requirements for filling out Form 4009?
A: Yes, pregnant individuals with opioid/opiate use disorder must read and understand the contents of Form 4009 and sign it in the presence of a witness.

Q: Is Form 4009 only for residents of Texas?
A: Yes, Form 4009 is specifically for individuals seeking treatment for opioid/opiate use disorder in Texas.

ADVERTISEMENT

Form Details:

  • Released on February 1, 2019;
  • The latest edition provided by the Texas Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form 4009 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.

Download Form 4009 Informed Consent for Pregnant Opioid / Opiate Use Disorder Individuals Seeking Treatment - Texas

4.6 of 5 (19 votes)
  • Form 4009 Informed Consent for Pregnant Opioid/Opiate Use Disorder Individuals Seeking Treatment - Texas

    1

  • Form 4009 Informed Consent for Pregnant Opioid/Opiate Use Disorder Individuals Seeking Treatment - Texas, Page 2

    2

  • Form 4009 Informed Consent for Pregnant Opioid / Opiate Use Disorder Individuals Seeking Treatment - Texas, Page 1
  • Form 4009 Informed Consent for Pregnant Opioid / Opiate Use Disorder Individuals Seeking Treatment - Texas, Page 2
Prev 1 2 Next
ADVERTISEMENT