Consent: Rules about Obtaining Consent to Disclose Treatment Information Bellefontaine 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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

Consolidated Care Inc
(937) 599-1975
118 Maple Street
Bellefontaine, OH
Services Provided
Substance abuse , Buprenorphine Services
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:
Consolidated Care Inc
(937) 653-5583
1522 East U.S. Highway 36
Urbana, OH
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Meridian Services Inc
(330) 797-0070
550 West Chalmers Avenue
Youngstown, OH
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

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:
Kennedy Clinic Outpatient
(614) 210-0416x7141
6543 Commerce Parkway
Dublin, OH
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Mercy Memorial Hospital
(937) 653-3001
904 Scioto Street
Urbana, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Community Health Center
(330) 315-4901
380 South Portage Path
Akron, OH
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
New Destiny Treatment Center
(330) 825-5202x110
6694 Taylor Road
Clinton, OH
Services Provided
Substance abuse , Halfway house, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
North Coast Center Inc
(440) 953-9999
38879 Mentor Avenue
Willoughby, OH
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

Data Provided by:
Perry Behavioral Health Choices Inc
(740) 342-1991
203 North Main Street
New Lexington, OH
Services Provided
Substance abuse
Types of Care
Outpatient
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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