Consent: Rules about Obtaining Consent to Disclose Treatment Information Horn Lake MS

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Memphis City Schools Mental Health Ctr
(901) 416-5810
2930 Airways Boulevard
Memphis, TN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

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Southeast Mental Health Center Inc
(901) 369-1400x1214
3810 Winchester Road
Memphis, TN
Hotline
(901) 369-1400
Services Provided
Substance abuse
Types of Care
Outpatient

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Communicare
(662) 429-7875
185 West Center Street
Hernando, MS
Hotline
(662) 234-7521
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, Persons with HIV/AIDS, Women, DUI/DWI offenders

Data Provided by:
Whitehaven Southwest Mental Health Ctr
(901) 259-1920x150
1087 Alice Avenue
Memphis, TN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Foundations Associates
(901) 969-5538
2009 Lamar Avenue
Memphis, TN
Hotline
(877) 345-3347x0
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), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Synergy Treatment Centers
(901) 332-2227
2305 Airport Interchange
Memphis, TN
Services Provided
Substance abuse , Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Cocaine and Alcohol Awareness Program
(901) 360-0442
4023 Knight Aronld Street
Memphis, TN
Hotline
(901) 367-7550
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Delta Medical Center
(901) 369-6021
3000 Getwell Street
Memphis, TN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Parkwood Behavioral Health System
(662) 895-4900
8135 Goodman Road
Olive Branch, MS
Hotline
(662) 893-7065
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Harbor House Inc
(901) 743-1836x2228
1979 Alcy Road
Memphis, TN
Hotline
(615) 780-5901
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

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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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