Consent: Rules about Obtaining Consent to Disclose Treatment Information Cambria Heights NY

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

North Shore Long Isl Jewish Health Sys
(516) 437-0440
40 Elmont Road
Elmont, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients

Data Provided by:
Friends of Bridge Inc
(516) 825-4242
5-11 Pflug Place
Valley Stream, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients

Data Provided by:
New Spirit II Inc
(718) 291-4844
162-04 South Road
Jamaica, NY
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with HIV/AIDS, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Long Island Jewish Medical Center
(718) 470-8940
Littauer Building/First Floor
Glen Oaks, NY
Services Provided
Substance abuse , Detoxification, Methadone Maintenance
Types of Care
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:
Interline Employee Assistance Prog Inc
(718) 206-1368
148-39 Hillside Avenue
Jamaica, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men, DUI/DWI offenders
Language Services
Polish, Russian, Ukrainian

Data Provided by:
Queens Village Committee for Mental
(718) 712-7777
17733 Baisley Boulevard
Jamaica, NY
Hotline
(800) 216-5227
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, Persons with HIV/AIDS, Seniors/older adults, Women, Men

Data Provided by:
Creedmoor Addiction Treatment Center
(718) 264-3740
8045 Winchester Boulevard
Queens Village, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women, Women, Men, Criminal justice clients
Language Services
Spanish

Data Provided by:
Peninsula Counseling Center
(516) 872-9698
73 South Central Avenue
Valley Stream, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Samaritan Village Inc
(718) 657-6195
8883 Van Wyck Expressway
Jamaica, NY
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, Persons with HIV/AIDS

Data Provided by:
Mary Immaculate Hospital
(718) 526-0101
14718 Archer Avenue
Jamaica, NY
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, Pregnant/postpartum women

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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