Consent: Rules about Obtaining Consent to Disclose Treatment Information Bullhead City AZ

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Mohave Mental Health Clinic
(928) 758-5905
1145 Marina Boulevard
Bullhead City, AZ
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Westcare Nevada Inc
(702) 299-0142
3650 South Pointe Circle
Laughlin, NV
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients

Data Provided by:
Valle Del Sol Inc
(602) 258-6797x194
1209 South 1st Avenue
Phoenix, AZ
Services Provided
Substance abuse , Methadone Maintenance, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women
Language Services
ASL or other assistance for hearing impaired, Arabic, Spanish

Data Provided by:
La Frontera Center
(520) 884-8470
260 South Scott Avenue
Tucson, AZ
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women, Women, Men
Language Services
Spanish

Data Provided by:
Pinal County Hispanic Council
(520) 466-7765
712 North Main Street
Eloy, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Community Medical Services LLC
(928) 763-7111
809 Hancock Road
Bullhead City, AZ
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient

Data Provided by:
Lois Faust Fazio
(928) 344-9894
661 East 32nd Street
Yuma, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Family Service Agency
(602) 264-9891
2400 North Central Ave
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Community Medical Services LLC
(928) 714-0010
2559 East 7th Avenue
Flagstaff, AZ
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

Data Provided by:
Haven
(520) 623-4590
1107 East Adelaide Drive
Tucson, AZ
Hotline
(520) 623-4590
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with HIV/AIDS, Women, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired, Navajo, 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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