Consent: Rules about Obtaining Consent to Disclose Treatment Information Dyersburg TN

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Professional Care Services of
(731) 287-1794
2380 Henry Street
Dyersburg, TN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Delta Medical Center
(901) 369-6021
3000 Getwell Street
Memphis, TN
Services Provided
Substance abuse , 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
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Comprehensive Community Services
(423) 349-4070
6145 Temple Star Road
Kingsport, TN
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Professional Care Services of
(731) 635-3968
403 Commerce Street
Ripley, TN
Hotline
(800) 353-9918
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Quinco Mental Health Center
(731) 925-5054
1105 Pickwick Road
Savannah, TN
Hotline
(800) 467-2515
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Gibson Recovery Center
(573) 333-3350
1206 Ward Avenue
Caruthersville, MO
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Samaritan Recovery Community Inc
(615) 244-4802
319 South 4th Street
Nashville, TN
Services Provided
Substance abuse , Halfway house
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

Data Provided by:
Cherokee Health Systems
(865) 992-3849
4330 Maynardville Highway
Maynardville, TN
Hotline
(865) 992-3849
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Hiwassee Mental Health Center/Athens
(423) 745-8802
1805 Ingleside Avenue
Athens, TN
Hotline
(800) 704-2651
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Peninsula Hospital
(865) 970-9800
2347 Jones Bend Road
Louisville, TN
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

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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