Consent: Rules about Obtaining Consent to Disclose Treatment Information Bettendorf IA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

New Life Outpatient Center Inc
(563) 355-0055
Paul Revere Square Suite 200 North
Davenport, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

Data Provided by:
Rock Island Cnty Council on Addictions
(309) 792-0292
1607 John Deere Expressway
East Moline, IL
Hotline
(309) 792-0292
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Center for Alcohol and Drug Services
(563) 326-4116
1519 East Locust Street
Davenport, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Center for Alcohol and Drug Servs Inc
(309) 792-4899
801 Illini Drive
Silvis, IL
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)

Data Provided by:
Robert Young Center CMHC
(309) 779-2800
2701 17th Street
Rock Island, IL
Hotline
(309) 779-2999
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Tri County Alcohol and Drug Servs LLC
(309) 752-9740
926 15th Avenue
East Moline, IL
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with HIV/AIDS, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Psychological Services Inc
(309) 757-9000
4324 7th Street
Moline, 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

Data Provided by:
River Bend Christian Counseling Inc
(309) 757-0300
111 19th Avenue
Moline, IL
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Family Counseling and Psychology Ctr
(309) 788-6374
303 18th Street
Rock Island, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Center for Alcohol and Drug Servs Inc
(309) 788-4571
4230 11th Street
Rock Island, IL
Services Provided
Substance abuse , Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Women, DUI/DWI offenders
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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