CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

Qualified Service Organization Agreement

XYZ Service Center ("The Center") and the ________________________ (name of program) ("the Program") hereby enter into a qualified service organization agreement, whereby the Center agrees to provide the following services:

(Nature of services to be provided)

Furthermore, the Center:

1. Acknowledges that in receiving, storing, processing, or otherwise dealing with any information from the Program about the clients in the Program, it is fully bound by the provisions of the Federal Regulations governing Confidentiality of Alcohol and Drug Abuse Client Records, 42 C.F.R. Part 2; and
2. Undertakes to resist, in judicial proceedings, any effort to obtain access to information pertaining to clients otherwise than as expressly provided for in the Federal confidentiality regulations, 42 C.F.R. Part 2.

Executed this ________ day of _______, 200__.

______________________

President Program Director

XYZ Service Center (Name of Program)

(Street Address)
(City, State, Zip)

Source:

Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Substance Abuse Treatment and Domestic Violence, Treatment Improvement Protocol 25, 1997.