Consent: Rules about Obtaining Consent to Disclose Treatment Information Elkhorn 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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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:
Fond Du Lac County
(920) 929-3500
459 East 1st Street
Fond Du Lac, WI
Hotline
(920) 929-3535
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Ashland Area Council on
(715) 682-5207
502 West Main Street
Ashland, WI
Hotline
(715) 682-5207
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Family Counseling Services of Wausau
(715) 842-3346
903 2nd Street
Wausau, WI
Hotline
(715) 842-3346
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Green Lake County
(920) 294-4070
500 Lake Steel Street
Green Lake, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Behavioral Medicine Center
(262) 928-4068
240 Maple Avenue
Mukwonago, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Quality Addiction Management (QAM)
(262) 598-1392
6233 Bankers Road
Racine, WI
Services Provided
Substance abuse treatment, Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

Data Provided by:
MARCO Services Inc
(920) 684-0605
1114 South 11th Street
Manitowoc, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Genesis Behavioral Services Inc
(262) 633-5001
1654 Washington Avenue
Racine, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Pauquette Center for
(608) 742-5518
2901 Hunters Trail
Portage, WI
Hotline
(608) 742-5344
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

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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