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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

McNeal Hospital
(708) 783-3140
3249 South Oak Park Avenue
Berwyn, IL
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
Spanish

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Chicago Treatment and
(708) 656-9500
1849 South Cicero Avenue
Cicero, IL
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

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Vet Affairs/Edward Hines Jr Hospital
(708) 202-8387
Roosevelt Road and 5th Avenue
Hines, IL
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

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Addiction Recovery Services, Inc.
(773) 581-2121
5514 South Archer Avenue
Chicago, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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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

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Pro Health Advocates Inc
(708) 652-7190
5929 West Roosevelt Avenue
Cicero, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

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Confidential DUI Services
(708) 222-0003
5101 West Roosevelt Road
Cicero, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, DUI/DWI offenders, Criminal justice clients
Language Services
German, Spanish

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Resurrection Addiction Services
(312) 563-3600
610 South Maple Avenue
Oak Park, IL
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men

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Loretto Hospital
(773) 854-5445
645 South Central Avenue
Chicago, IL
Hotline
(800) 592-8120
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
New Age Services Corporation
(773) 542-1150x113
1330 South Kostner Avenue
Chicago, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Men
Language Services
ASL or other assistance for hearing impaired

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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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