Consent: Rules about Obtaining Consent to Disclose Treatment Information Derry NH

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Quitting Time At Hampstead Hospital
(603) 329-5833
218 East Road
Hampstead, NH
Services Provided
Substance abuse
Types of Care
Outpatient

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Metro Treatment of New Hampshire LP
(603) 622-5005
5 Driving Park Road
Manchester, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient

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Serenity Place
(603) 625-6980
93-101 Manchester Street
Manchester, NH
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

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Habit Management
(603) 622-4747
20 Market Street
Manchester, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women, Women

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NH Div Alcohol/Drug Abuse Prevention
(603) 668-2971
15-17 Brook Street
Manchester, NH
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men

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Silverman and Associates Inc
(603) 329-6440
2 Village Green Road
Hampstead, NH
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Seniors/older adults, Men

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Merrimack River Medical
(603) 595-3399
323 Derry Road
Hudson, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women, Women, Men
Language Services
Spanish

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Farnum Center
(603) 622-3020x11
235 Hanover Street
Manchester, NH
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient

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Child and Family Services
(603) 518-4304
99 Hanover Street
Manchester, NH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Greater Nashua Council on Alcoholism
(603) 881-4848
Pine Street Extension
Nashua, NH
Hotline
(603) 881-4848
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
Special Programs/Groups
Women, Men, Criminal justice clients

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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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