Consent: Rules about Obtaining Consent to Disclose Treatment Information Arlington Heights IL

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Bridge Youth and Family Services
(847) 359-7490
721 South Quentin Road
Palatine, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
Therapeutic Interventions Inc
(847) 991-4800x27
1645 Hicks Road
Rolling Meadows, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Women, Men
Language Services
Spanish

Data Provided by:
Omni Youth Services
(847) 253-6010
1616 North Arlington Heights Road
Arlington Heights, IL
Hotline
(847) 353-1500
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
Polish, Russian, Spanish

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Counseling Center of Illinois
(773) 777-6767
115 South Wilke Road
Arlington Heights, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Polish, Russian, Serbian, Spanish

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Adult Counseling and Educational Servs
(847) 593-6201
415 East Golf Road
Arlington Heights, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Families and Adolescents In Recovery
(847) 359-5192
1995 Hicks Road
Rolling Meadows, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
Polish

Data Provided by:
Rolling Meadows Counseling Center
(847) 991-5710
1835 Hicks Road
Rolling Meadows, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Northwest Community Hospital
(847) 618-2700
901 West Kirchoff Road
Arlington Heights, IL
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

Data Provided by:
Arlington Center for Recovery LLC
(847) 427-9680
1655 S Arlington Heights Road 200
Arlington Heights, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Omni Youth Services
(847) 541-0199
210 North Wolf Road
Wheeling, IL
Hotline
(847) 353-1500
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
Polish, Russian, 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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