Consent: Rules about Obtaining Consent to Disclose Treatment Information Delavan WI

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Aro Counseling Centers Inc
(262) 723-1455
797 East Geneva Street
Elkhorn, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Red Cliff Tribe
(715) 779-3741
North Braddum Road off Blueberry Road
Bayfield, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient

Data Provided by:
La Casa de Esperanza
(262) 928-4402
210 NW Barstow Street
Waukesha, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Men, DUI/DWI offenders, Criminal justice clients
Language Services
French, German, Italian, Polish, Spanish, Vietnamese

Data Provided by:
Arbor Place Inc
(715) 235-4537x106
320 21st Street NE
Menomonie, WI
Services Provided
Substance abuse treatment, 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
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Genesis Behavioral Services Inc
(262) 681-3202
4107-4109 Saint Clair Street
Racine, WI
Services Provided
Substance abuse treatment
Types of Care
Residential long-term treatment (more than 30 days)

Data Provided by:
Rock Valley Community Programs Inc
(608) 741-4500
203 West Sunny Lane Road
Janesville, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Criminal justice clients

Data Provided by:
Aurora Psychiatric Hospital
(414) 454-6600
1220 Dewey Avenue
Wauwatosa, WI
Services Provided
Substance abuse treatment, Detoxification, Methadone Detoxification, Halfway house, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

Data Provided by:
Behavioral Health Services of
(715) 685-5400x5408
1635 Maple Lane
Ashland, WI
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
North Central Healthcare Facilities
(715) 848-4600
1100 Lakeview Drive
Wausau, WI
Hotline
(800) 799-0122
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Saint Clare Center
(608) 356-1533
1510 Jefferson Street
Baraboo, WI
Hotline
(800) 433-2688
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Seniors/older adults, Pregnant/postpartum women, Women, Men

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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