Consent: Rules about Obtaining Consent to Disclose Treatment Information Green Valley AZ

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

Centro de Amistad Inc
(480) 833-0227
460 North Mesa Drive
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Mohave Mental Health Clinic
(928) 758-5905
1145 Marina Boulevard
Bullhead City, AZ
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Southwest Behavioral Health Servs Inc
(928) 474-3303
404 West Aero Drive
Payson, AZ
Hotline
(928) 474-3303
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
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Decision Point Center Inc
(928) 778-4600
505 West Whipple Street
Prescott, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Women, Men

Data Provided by:
Rosewood Women''s Center
(800) 845-2211
36075 South Rincon Road
Wickenburg, AZ
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Calvary Center
(602) 279-1468
720 East Montebello Avenue
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)

Data Provided by:
Casa de Amigas
(602) 265-9987
1648 West Colter Street
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Women, Criminal justice clients

Data Provided by:
Chandler Valley Hope Alcohol/Drug and
(480) 899-3335
501 North Washington Street
Chandler, AZ
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
La Frontera Center
(520) 792-0591
1900 West Speedway Boulevard
Tucson, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men

Data Provided by:
Arizona Treatment Institute LLC
(520) 836-9788
1927 North Trekell Road
Casa Grande, AZ
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, 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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