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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

FACTS/New Alternatives
(740) 446-7866
45 Olive Street
Gallipolis, OH
Hotline
(740) 446-5554
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Pregnant/postpartum women, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

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Health Recovery Services Inc
(740) 992-5277
138 North 2nd Avenue
Middleport, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

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Southwest General Health Ctr/Oakview
(440) 816-8200x5756
18697 Bagley Road
Middleburg Heights, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired

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Travco Behavioral Health Services
(740) 284-0163
820 North 4th Street
Steubenville, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired, Spanish

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North Community Counseling Centers Inc
(614) 846-2588
4897 Karl Road
Columbus, OH
Hotline
(614) 276-2273
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Prestera Center for MH Services Inc
(304) 675-2361x3510
Mason County Office
Point Pleasant, WV
Hotline
(800) 642-3434
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

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Matt Talbot for Women
(216) 592-2800x11
2351 East 22nd Street
Cleveland, OH
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Residential beds for clients' children, Criminal justice clients

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Public Health Dayton and Montgomery Co
(937) 461-5223x3017
One Elizabeth Place
Dayton, OH
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Adolescents, Women
Language Services
ASL or other assistance for hearing impaired

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:
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

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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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