Renaissance Ranch-Heyburn Research Permission

I agree to participate in progress monitoring research designed to improve the effectiveness of the treatment I receive during the time I am enrolled at Renaissance Ranch-Heyburn (“Heyburn”). This monitoring will include information about potential mental health conditions, current and previous drug and alcohol use, and satisfaction with treatment. I understand that this monitoring will be conducted by Vista Research Group, Inc. (“Vista”) using online surveys, and that all information I provide while I’m attending this treatment program will be immediately shared with the clinician(s) and/or the leadership of Heyburn so that it can be used to improve my treatment. I agree that Vista may use email or text messaging to send me links to the surveys as well as a copy of this consent form.

I also agree that Vista may contact me periodically during the first 13 months after I leave Heyburn to determine how well I am doing. Information I provide after treatment will be kept strictly confidential and will only be provided to the leadership of Heyburn after it has been deidentified and combined with that of many other patients. The only exception to this would be if I specifically request that Vista notify Heyburn that I would like to be contacted by them to potentially consider going back into treatment. This post-treatment outcomes research is designed to help Heyburn improve the treatment it provides to future clients. As I’m not benefitting directly from this portion of the research, I will receive a small stipend in appreciation for my time.

I give Vista permission to send me links to the surveys, gift cards, and a copy of this agreement by email or text. I also give permission for gift cards and a copy of this agreement to be sent to me through the mail, and for Vista researchers to call me if they are unable to reach me via email or text.

I also agree that Heyburn may share with Vista my name, medical record number, birthdate, gender, phone number(s), email address, the name and type of my health plan, the name(s) of my primary clinicians, and the dates and reasons why I am admitted, transferred and discharged from Heyburn’s program(s).

I understand that health information that may be used to identify me is protected under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and 45 C.F.R. Parts 160 and 164. The confidentiality of my health information may also be protected under 42 C.F.R. Part 2. I understand that my personally-identifiable health information and/or substance use disorder records cannot be disclosed without my written consent unless otherwise provided for by these federal regulations.

If I am under the age of 18, I understand that a parent or guardian will also be asked to agree to my participation, unless state law allows me to consent to treatment on my own.

I understand that permission to contact me expires 13 months after I have left Heyburn, and that I have the right to revoke this authorization at any time by emailing research@vista-research-group.net. Finally, I understand that my enrollment at Heyburn is not contingent upon my involvement in this research.

Do you want to join a community of treatment professionals who are fervently committed to providing every patient with the best possible chance of recovering from addiction and/or mental illness? Members of the Vista Research Network use state-of-the-art software to monitor patients during treatment and follow up with them afterwards to learn how effective their treatment was in helping them recover. Not only are clinicians able to use to easily personalize the treatment they provide, but Vista’s trailblazing data analytics platform and comprehensive research reports help owners and managers continually monitor and improve their center’s effectiveness.

Vista Research Group monitors your patients during treatment and follows up with them afterwards so you can help more of your patients recover from addiction.

Once Vista’s research agreement is signed, a 30-minute Implementation Meeting will be scheduled with your leadership team to understand how your center is structured and what data you want to collect. After this meeting, the only additional information Vista will need is a list of users needing access to the software. Vista is usually able to customize the software for a new center within 24 hours of receiving this patient list.

During online training sessions, Vista will explain why progress monitoring helps patients get better faster, demonstrate the key features of the software, discuss best practices, and answer any questions your team has.

Training videos and step-by-step instructions are available in Vista’s private community as well as in a searchable Knowledge Base. Vista also provides live phone and email support seven days a week to answer any questions new users might have.