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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

DUI Associates
(847) 548-1966
1826 East Belvedere Road
Grayslake, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Renacer Latino Inc
(847) 336-7302
900 North Lake Street
Mundelein, IL
Hotline
(847) 336-7302
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Pregnant/postpartum women, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Bosnian, German, Hungarian, Polish, Portugese, Russian, Serbian, Spanish

Data Provided by:
Omni Youth Services
(847) 949-1020
115 North Seymour Avenue
Mundelein, IL
Hotline
(847) 353-1500
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
Polish, Russian, Spanish

Data Provided by:
Addictions Associates Inc
(847) 549-0083
322 Peterson Road
Libertyville, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Gateway Foundation Inc
(847) 356-8205x3337
25480 West Cedarcrest Lane
Lake Villa, IL
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Northern Illinois Council on Alc and
(847) 546-6540
31979 North Fish Lake Road
Round Lake, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
DUI and Addiction Counseling Center
(847) 949-4596
333 East Route 83
Mundelein, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Behavioral Services Center
(847) 673-8577
708 Florsheim Drive
Libertyville, IL
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
Lithuanian, Polish, Russian, Spanish

Data Provided by:
Alliance Institute For The
(847) 680-3828
501 West Peterson Road
Libertyville, IL
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Weckler and Associates LTD
(847) 662-5588
68 Ambrogio Drive
Gurnee, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Men, 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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