Consent: Rules about Obtaining Consent to Disclose Treatment Information Bemidji MN

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Lakes Region
(218) 444-5740
1510 Bemidji Avenue North
Bemidji, MN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders

Data Provided by:
Evergreen Youth Recovery House
(218) 751-2466
820 Beltrami Avenue
Bemidji, MN
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents

Data Provided by:
Leech Lake Outpatient Program
(218) 335-3567
115 Sixth Street NW
Cass Lake, MN
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Pregnant/postpartum women, Women, Men

Data Provided by:
Stellher Human Services Inc
(218) 444-2845
315 Main Street West
LaPorte, MN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Criminal justice clients

Data Provided by:
Cambridge Medical Center
(763) 689-7723x8222
701 South Dellwood Avenue
Cambridge, MN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

Data Provided by:
Northern Lakes Clinic Inc
(218) 755-5170
301 America Avenue NW
Bemidji, MN
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men

Data Provided by:
Upper MN Mental Health Center
(218) 751-3280
722 15th Street
Bemidji, MN
Hotline
(800) 422-0045
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Leech Lake Opioid Program
(218) 335-4525
110 Balsam Avenue
Cass Lake, MN
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults

Data Provided by:
Guest House Inc
(507) 288-4693
4800 48th Street NE
Rochester, MN
Hotline
(800) 634-4155
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
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Men
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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