Consent: Rules about Obtaining Consent to Disclose Treatment Information Burlington NC

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Residential Treatment Services of
(336) 227-7417
Hall Avenue Facility
Burlington, NC
Services Provided
Substance abuse , Detoxification, Halfway house, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Alamance Regional Medical Center Inc
(336) 538-7888
1240 Huffman Mill Road
Burlington, NC
Hotline
(336) 538-7887
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Fellowship Hall Inc
(800) 659-3381
5140 Dunstan Road
Greensboro, NC
Services Provided
Substance abuse , Detoxification, Halfway house, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Mary''s House
(336) 275-0820
520 Guilford Avenue
Greensboro, NC
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Assessment Counseling and
(336) 272-1630
436 Spring Garden Street
Greensboro, NC
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
ADS Alcohol and Drug Services
(336) 532-0500
2140 North Church Street
Burlington, NC
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Life Changes Counseling
(336) 228-7600
204 East Elm Street
Graham, NC
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Ted Bissette
(336) 272-7079
315 Hughes Street
Greensboro, NC
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Ringer Center
(336) 379-7146
213 East Bessemer Avenue
Greensboro, NC
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

Data Provided by:
Alcohol and Drug Services
(336) 333-6860
301 East Washington Street
Greensboro, NC
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Women, DUI/DWI offenders, Criminal justice clients

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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