Consent: Rules about Obtaining Consent to Disclose Treatment Information Alexandria VA

Most general rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31). To be valid, a consent form must be in writing and must contain each of the items specified in §2.31.

Alexandria Community Services Board
(703) 838-4525
2355-A Mill Road
Alexandria, VA
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Arabic, Chinese, French, German, Korean, Portugese, Russian, Spanish, Vietnamese

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Boys and Girls Recovery Lodges
(703) 841-0703x211
521 North Quincy Street
Arlington, VA
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

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Virginia Hospital Center
(703) 558-6451
1701 North George Mason Drive
Arlington, VA
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment

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Federal City Recovery Services
(202) 562-4939
920 Bellevue Street SE
Washington, DC
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Men, Criminal justice clients

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Women''s Home Inc
(703) 237-2822
1628 North George Mason Drive
Arlington, VA
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women

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Ethos Foundation
(703) 535-6800
312 South Washington Street
Alexandria, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Vanguard Services Unlimited
(703) 841-0660
521 Quincy Street
Arlington, VA
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Arlington County Behavioral Healthcare
(703) 228-4900
1725 North George Mason Drive
Arlington, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Concerned Citizens on
(202) 563-3209
3115 Martin Luther King Avenue SE
Washington, DC
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Pregnant/postpartum women, Women, DUI/DWI offenders

Data Provided by:
Living Free Health Services
(703) 750-1292
4306 Evergreen Lane
Annandale, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Data Provided by:

Consent: Rules about Obtaining Consent to Disclose Treatment Information

Consent: Rules About Obtaining Consent To Disclose Treatment Information

The most frequently used exception to the regulations’ general rule prohibiting disclosure is client consent. (Parental consent must also be obtained in some States. See below.) The regulations’ requirements regarding consent are strict and somewhat unusual and must be carefully followed.

Most disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31). To be valid, a consent form must be in writing and must contain each of the items specified in §2.31:

1. The name or general description of the program(s) making the disclosure

2. The name or title of the individual or organization that will receive the disclosure

3. The name of the client who is the subject of the disclosure

4. The purpose or need for the disclosure

5. How much and what kind of information will be disclosed

6. A statement that the client may revoke (take back) the consent at any time, except to the extent that the program has already acted on it

7. The date, event, or condition upon which the consent will expire if not previously revoked

8. The signature of the client (and, in some States, his or her parent)

9. The date on which the consent is signed (§2.31(a)).

A general medical release form, or any consent form that does not contain all of the elements listed above, is not acceptable. (See the sample consent form in exhibit 3–1.) ...

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