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Consent: Rules about Obtaining Consent to Disclose Treatment Information Burke VA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Living Free Health Services
(703) 750-1292
4306 Evergreen Lane
Annandale, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Fairfax Methadone Treatment Center
(703) 333-3113
7008 Little River Turnpike
Annandale, VA
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

Data Provided by:
Fairfax Falls Church CSB ADS
(703) 934-5476
3900 Jermantown Road
Fairfax, VA
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, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Inova Comprehensive Addiction
(703) 776-7777
3300 Gallows Road
Falls Church, VA
Services Provided
Substance abuse , Detoxification, Methadone Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired, French, Portugese, Spanish

Data Provided by:
Arlington County Behavioral Healthcare
(703) 228-4900
1725 North George Mason Drive
Arlington, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Life Line Counseling Center
(703) 691-3029
10374 Democracy Lane
Fairfax, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Harrison House of Virginia
(703) 256-6474
5105 Q Backlick Road
Annandale, VA
Services Provided
Substance abuse , Halfway house, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Women, Men

Data Provided by:
Inova Kellar Center Behavioral
(703) 218-8500
11204 Waples Mill Road
Fairfax, VA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Women''s Home Inc
(703) 237-2822
1628 North George Mason Drive
Arlington, VA
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women

Data Provided by:
Virginia Hospital Center
(703) 558-6451
1701 North George Mason Drive
Arlington, VA
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment

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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