Consent: Rules about Obtaining Consent to Disclose Treatment Information Farmingville NY

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

YMCA of Long Island
(631) 580-7777
2545 Middle Country Road
Centereach, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders

Data Provided by:
Phoenix House
(631) 471-5666x5531
153 Lake Shore Road
Ronkonkoma, NY
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Men, Criminal justice clients

Data Provided by:
Phoenix Houses of Long Island
(631) 471-5666
153A Lake Shore Road
Lake Ronkonkoma, NY
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Residential beds for clients' children

Data Provided by:
Catholic Charities/Talbot House
(631) 589-4144
30 Carlough Road
Bohemia, NY
Hotline
(631) 589-4144
Services Provided
Detoxification
Types of Care
Residential short-term treatment (30 days or less)

Data Provided by:
Saint Charles Hospital
(631) 474-6233
200 Belle Terre Road
Port Jefferson, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Seafield Services Inc
(631) 451-6007
2852-C Route 112
Medford, NY
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Community Counseling Services of
(631) 471-3122
3281 Veterans Memorial Highway
Ronkonkoma, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
John T Mather Memorial Hospital
(631) 331-8200
208 Route 112
Port Jefferson Station, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders

Data Provided by:
Counseling Mediation/Forensic Services
(631) 218-0968
30 Floyd Run
Bohemia, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders

Data Provided by:
Outreach Development Corporation
(631) 286-0700x112
11 Farber Drive
Bellport, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

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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