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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Chautauqua County Department of
(716) 363-3550
319 Central Avenue
Dunkirk, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men

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Cattaraugus Indian Reservation Health
(716) 532-5583
36 Thomas Indian School Drive
Irving, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men

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Saint Josephs Rehabilitation Center
(845) 483-7051
7 Fallkill Place
Poughkeepsie, NY
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Men

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TLC Hlth Net Tri County Memorial Hosp
(716) 532-8900x8749
100 Memorial Drive
Gowanda, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women, Women
Language Services
ASL or other assistance for hearing impaired

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Staten Island University Hospital
(718) 307-3000
567 East 105th Street
Brooklyn, NY
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS
Language Services
Spanish

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TLC Health Tri County
(716) 595-3355x1206
33 North Main Street
Cassadaga, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women

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Chautauqua County Department of MH
(716) 661-8330x8374
200 East 3rd Street
Jamestown, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients

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Family Youth Center
(718) 245-2541
604 Winthrop Street
Brooklyn, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
NRI Group LLC
(212) 957-0776
455-458 West 50th Street
New York, NY
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)
Language Services
Spanish

Data Provided by:
MH Providers of Western Queens Inc
(718) 898-5085
6207 Woodside Avenue
Woodside, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

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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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