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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Mansfield Urban Minority Alc and
(419) 525-3525
400 Bowman Street
Mansfield, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Center for Individual and
(419) 756-1717
741 Scholl Road
Mansfield, OH
Hotline
(419) 522-4357
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Foundation For Living
(419) 589-5511x212
1451 Lucas Road
Mansfield, OH
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, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Morgan Behavioral Health Choices
(740) 962-6933x23
915 South Riverside Drive
Mc Connelsville, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Sojourner Home
(513) 868-0544
449 North 3rd Street
Hamilton, OH
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Cornell Abraxas Group Inc
(419) 747-3322
2775 State Route 39
Shelby, OH
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, Persons with HIV/AIDS, Criminal justice clients

Data Provided by:
New Beginnings Recovery Services
(419) 526-6168
270 Sterkel Boulevard
Mansfield, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Pregnant/postpartum women, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Consolidated Care Inc
(937) 644-9192
715 South Plum Street
Marysville, OH
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Laurelwood Counseling Center of
(216) 595-0500
23240 Chagrin Boulevard
Beachwood, OH
Hotline
(440) 953-3000
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Italian, Spanish

Data Provided by:
Psychiatric and Psychological Services
(440) 323-5121
750 South Abbe Road
Elyria, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

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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