Consent: Rules about Obtaining Consent to Disclose Treatment Information Euclid OH

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Moore Counseling and Mediation
(216) 404-1900
22639 Euclid Ave
Euclid, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Northern Ohio Recovery Association
(213) 451-5443
2114 Noble Road
East Cleveland, OH
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Cleveland Health Department
(216) 664-3891
11100 Saint Clair Avenue
Cleveland, OH
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
North Coast Center Inc
(440) 953-9999
38879 Mentor Avenue
Willoughby, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Kaiser Permanente Medical Center
(216) 265-6800
10 Severance Circle
Cleveland Heights, OH
Hotline
(216) 265-6800
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Huron Hospital
(216) 761-3300
13951 Terrace Road
East Cleveland, OH
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Hitchcock Center for Women Inc
(216) 421-0662x104
1227 Ansel Road
Cleveland, OH
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), Outpatient
Special Programs/Groups
Pregnant/postpartum women, Women, Residential beds for clients' children

Data Provided by:
Laurelwood Hospital
(440) 953-3000
35900 Euclid Avenue
Willoughby, OH
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Bellefaire Jewish Children''s Bureau
(216) 932-2800x8267
22001 Fairmount Boulevard
Shaker Heights, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women
Language Services
Spanish

Data Provided by:
Free Medical Clinic of
(216) 721-4010
12201 Euclid Avenue
Cleveland, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Men, 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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