Consent: Rules about Obtaining Consent to Disclose Treatment Information Jackson Heights NY

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

MH Providers of Western Queens Inc
(718) 898-5085
6207 Woodside Avenue
Woodside, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
City Hospital Center at Elmhurst (CHC)
(718) 334-4660
8130 Baxter Avenue
Elmhurst, NY
Hotline
(718) 334-4000
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Elmcor Youth and Adult Activities Inc
(718) 651-0096
107-20 Northern Boulevard
Corona, NY
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
HANAC Inc
(718) 204-1200
3114 30th Avenue
Astoria, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

Data Provided by:
Community Related Services Inc
(718) 997-1901
9907 Queens Boulevard
Forest Hills, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men, DUI/DWI offenders
Language Services
Farsi, Russian

Data Provided by:
Inwood Community Services Inc
(212) 942-0043x132
651 Academy Street
New York, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Criminal justice clients
Language Services
Spanish

Data Provided by:
Elmhurst Hospital Center
(718) 334-3190
7901 Broadway
Flushing, NY
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women
Language Services
Greek, Hebrew, Maltese, Spanish

Data Provided by:
Child Center of NY Asian Outreach
(718) 899-9810x200
8708 Justice Avenue
Elmhurst, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Bengali, Chinese, Farsi, Gujurati, Hindi, Korean, Tagalog, Urdu

Data Provided by:
QSA Inc /CD Outpatient Program
(718) 729-8686
35-01 Queens Boulevard
Long Island City, NY
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Seniors/older adults, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Creole, French, Russian, Spanish

Data Provided by:
Advanced Human Services Inc
(718) 261-3437
112-15 72ND ROAD
Forest Hills, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, DUI/DWI offenders
Language Services
Polish, Russian, Spanish, Ukrainian

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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