Consent: Rules about Obtaining Consent to Disclose Treatment Information Booneville MS

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Region IV MH/MR Commission
(662) 286-7199
401 New Hope Drive
Corinth, MS
Hotline
(888) 287-4443
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

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Victory Manor Recovery Center
(601) 924-9496
100 West Northside Drive
Clinton, MS
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

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Life Help
(662) 887-5441
200 East Baker Street
Indianola, MS
Hotline
(662) 453-6211
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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Golden Triangle Recovery Center Inc
(662) 324-2230
322 University Drive
Starkville, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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Region I Mental Health Center
(662) 326-4445
First Street
Marks, MS
Hotline
(662) 902-7296
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

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Hinds Behavioral Health Services
(601) 321-2400
3450 Highway 80 West
Jackson, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Pine Grove Recovery Center
(800) 321-8750
2255 Broadway Drive
Hattiesburg, MS
Hotline
(800) 321-8750x4812
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential long-term treatment (more than 30 days), Outpatient
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:
Ark
(601) 355-0077
1801 North West Street
Jackson, MS
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

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Communicare
(662) 412-3251
235 South Murphee Street
Pittsboro, MS
Hotline
(662) 234-7521
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders

Data Provided by:
Communicare
(662) 562-5216
101 Preston McKay Drive
Senatobia, MS
Hotline
(662) 234-7521
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
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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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