Consent: Rules about Obtaining Consent to Disclose Treatment Information Alliance OH

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

Quest Recovery Services
(330) 453-8252x183
724 South Union Avenue
Alliance, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Crisis Intervention/Recovery Ctr Inc
(330) 452-9812
832 McKinley Avenue NW
Canton, OH
Hotline
(330) 452-6000
Services Provided
Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less)
Language Services
ASL or other assistance for hearing impaired, Russian, Spanish

Data Provided by:
Trillium Family Solutions Inc
(330) 454-7066x350
101 Cleveland Avenue NW
Canton, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Mercy Medical Center Impact Program
(330) 489-1233x3
1320 Mercy Drive NW
Canton, OH
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment

Data Provided by:
Akron General Edwin Shaw Rehab
(330) 784-1271x5405
1621 Flickinger Road
Akron, OH
Services Provided
Substance abuse , Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Quest Recovery and Prevention Services
(330) 453-8252
1341 Market Avenue North
Canton, OH
Services Provided
Substance abuse , Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Community Based Outpatient Clinics
(330) 489-4600x1633
733 Market Avenue South
Canton, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Men, Criminal justice clients

Data Provided by:
Crisis Intervention & Recovery Center
(330) 588-2204
2421 13th Street NW
Canton, OH
Hotline
(330) 452-6000
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired, Russian, Spanish

Data Provided by:
Compass Recovery Center
(330) 298-9391
246 South Chestnut Street
Ravenna, OH
Hotline
(330) 298-9391
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Townhall II
(330) 678-3006
155 North Water Street
Kent, OH
Hotline
(330) 678-4357
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

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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