Consent: Rules about Obtaining Consent to Disclose Treatment Information Evergreen Park IL

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Center For Outpatient
(708) 425-3000
9730 South Western Avenue
Evergreen Park, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Men, DUI/DWI offenders

Data Provided by:
New Hope Community Service Center
(773) 737-9555
2559 West 79th Street
Chicago, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with HIV/AIDS, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Advocate Christ Medical Center
(708) 684-1337
4440 West 95th Street
Oak Lawn, IL
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Prevention Classes Inc
(773) 239-2830
10435 South Kedzie Avenue
Chicago, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Associates In Alcohol and
(708) 233-0161
8938 South Ridgeland Avenue
Oak Lawn, IL
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Little Company of Mary Hospital
(708) 422-0110
2800 West 95th Street
Evergreen Park, IL
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:
Crossmont and Associates Inc
(708) 229-0700
10522 South Cicero Avenue
Oak Lawn, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Women, DUI/DWI offenders
Language Services
Russian, Spanish

Data Provided by:
Lutheran Social Services of Illinois
(773) 881-1900x11
3220 West 115th Street
Chicago, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Fola Community Action Services Inc
(773) 487-4310
8014-8018 South Ashland Avenue
Chicago, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Men

Data Provided by:
Radius Foundation Inc
(708) 424-3085
10522 South Cicero Avenue
Oak Lawn, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women

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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