Consent: Rules about Obtaining Consent to Disclose Treatment Information Franklin 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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

Leyden Family Service
(847) 451-0330
10001 West Grand Avenue
Franklin Park, IL
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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Pilsen Little Village
(708) 343-7860
1633 North 37th Avenue
Melrose Park, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Seniors/older adults, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

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Youth Outreach Services
(773) 777-6377
6417 West Irving Park Road
Chicago, IL
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
Spanish

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New Leaf Counseling LLC
(847) 391-4180
1460 Renaissance Drive
Park Ridge, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

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Lutheran Social Services of Illinois
(773) 637-1144
5825 West Belmont Avenue
Chicago, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women

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Procare Centers
(708) 681-0073x5208
1414 West Main Street
Melrose Park, IL
Hotline
(708) 681-4357
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders
Language Services
Polish, Spanish

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Pilsen Little Village
(708) 410-0856
1546 North Mannheim Road
Stone Park, IL
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Norwood Park Township Family Services
(708) 867-6886
4600 North Harlem Avenue
Harwood Heights, IL
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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Maine Center
(847) 696-1376x413
832 Busse Highway
Park Ridge, IL
Hotline
(847) 696-1576
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
DUI Counseling Center
(773) 489-5200
4701 North Cumberland Avenue
Norridge, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Polish, Spanish

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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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