Consent: Rules about Obtaining Consent to Disclose Treatment Information Highland CA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Redlands Yucaipa Guidance Clinic Asso
(909) 425-9316
3694 East Highland Avenue
Highland, CA
Hotline
(888) 743-1478
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

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Redlands Yucaipa Guidance Clinic Asso
(909) 335-7067
1323 West Colton Avenue
Redlands, CA
Hotline
(888) 743-1478
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

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Pine Ridge Outpatient Center
(909) 890-0294
1881 Commercenter East
San Bernardino, CA
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment

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Casa de San Bernardino
(909) 381-5507
735 North D Street
San Bernardino, CA
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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Mental Health Systems Inc/(PRIDE)
(909) 386-0437
1874 Business Center Drive
San Bernardino, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
Spanish

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San Manuel Clinic
(888) 268-0008x240
2210 East Highland Avenue
San Bernardino, CA
Hotline
(888) 268-0008
Services Provided
Substance abuse
Types of Care
Outpatient

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New House/Women With Children Under
(909) 381-5396
856, 856-1, 856-2, and 856-3
San Bernardino, CA
Hotline
(909) 881-0390
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired, Spanish

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SAC Health Systems Norton
(909) 382-7135
1454 East Second Street
San Bernardino, CA
Hotline
(888) 743-1478
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Pregnant/postpartum women, Women, Men, Criminal justice clients
Language Services
Lakota, Navajo, Spanish

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Veterans Alcoholic Rehab Progs (VARP)
(909) 888-6956
384 11th Street
San Bernardino, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Veterans Alcoholic Rehab Prog (VARP)
(909) 888-6956
1149 North D Street
San Bernardino, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
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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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