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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Pilsen Little Village
(708) 343-7860
1633 North 37th Avenue
Melrose Park, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Seniors/older adults, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

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Procare Centers
(708) 681-0073x5208
1414 West Main Street
Melrose Park, IL
Hotline
(708) 681-4357
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders
Language Services
Polish, Spanish

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Way Back Inn Inc
(708) 344-3301
201 South 2nd Avenue
Maywood, IL
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women
Language Services
Polish, Spanish

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Changes Behavioral Services Inc
(708) 338-2274
1701 South 1st Avenue
Maywood, IL
Services Provided
Substance abuse
Types of Care
Outpatient

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Way Back Inn Inc
(708) 345-8422
1915 West Roosevelt Road
Broadview, IL
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Polish, Spanish

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Pilsen Little Village
(708) 410-0856
1546 North Mannheim Road
Stone Park, IL
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Substance Abuse Operations
(708) 343-1275
308 South 5th Avenue
Maywood, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Women, Men

Data Provided by:
Enhanced Clinical Solutions Inc
(708) 344-0884x206
1701 South 1st Avenue
Maywood, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Restoration MBS Center Inc
(708) 483-8320
1127 South Mannheim Road
Westchester, IL
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment

Data Provided by:
Pillars
(708) 698-5500
333 North LaGrange Road
La Grange Park, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

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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