Consent: Rules about Obtaining Consent to Disclose Treatment Information Jackson TN

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Jackson Area Council on
(731) 423-3653
900 East Chester Street
Jackson, TN
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Women, Men, DUI/DWI offenders

Data Provided by:
Aspell Recovery Center
(731) 427-7238
331 North Highland Avenue
Jackson, 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
Women, Men

Data Provided by:
Quinco Community Mental Health Center
(731) 664-2083
45 Executive Drive
Jackson, TN
Hotline
(800) 467-2515
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Jackson Professional Associates
(731) 660-0880
1869 Highway 45 Bypass
Jackson, TN
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Language Services
Spanish

Data Provided by:
Frontier Health Inc
(423) 989-4502
26 Midway Street
Bristol, TN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men

Data Provided by:
Pathways of Tennessee Inc
(731) 541-8200
238 Summar Drive
Jackson, TN
Hotline
(800) 372-0693
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Cumberland Heights Outpatient
(731) 660-2790
130 Stonebridge Boulevard
Jackson, TN
Hotline
(800) 646-9998
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Lakeside Behavioral Health System of
(731) 664-0010
135 Stonebridge Boulevard
Jackson, TN
Hotline
(800) 232-5253
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Quinco Mental Health Center
(731) 989-3401
925 East Main Street
Henderson, TN
Hotline
(800) 467-2515
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Peninsula Hospital
(865) 970-9800
2347 Jones Bend Road
Louisville, TN
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

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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