Consent: Rules about Obtaining Consent to Disclose Treatment Information Champaign IL

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Kathi Cullop
(217) 398-8067
1207 South Mattis Avenue
Champaign, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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Prairie Center Health Systems Inc
(217) 356-7576
122 West Hill Street
Champaign, IL
Hotline
(217) 356-7576
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

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Alcohol/Chemical Evaluation Services
(217) 344-2671
217 North Broadway Avenue
Urbana, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients

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Prairie Center Health Systems Inc
(217) 328-4500
718 Killarney Street
Urbana, IL
Hotline
(217) 356-7576
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Maine Center
(847) 696-1376x413
832 Busse Highway
Park Ridge, IL
Hotline
(847) 696-1576
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Mental Health Center of Champaign Cnty
(217) 398-7785
70 East Washington Street
Champaign, IL

Data Provided by:
Allison and Lawyer Counseling Servs PC
(217) 352-5533
2917 Crossing Court
Champaign, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients

Data Provided by:
Carle Addiction Recovery Center
(217) 383-6039
204 West University Avenue
Urbana, IL
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Gays and Lesbians, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Piatt County Mental Health Center
(217) 762-5371
1921 North Market Street
Monticello, IL
Hotline
(217) 762-4357
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women, Women, DUI/DWI offenders

Data Provided by:
Family Guidance Centers Inc
(847) 827-7517
484 Lee Street
Des Plaines, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient

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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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