Consent: Rules about Obtaining Consent to Disclose Treatment Information Jacksonville IL

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Wells Center
(217) 243-1871
1300 Lincoln Avenue
Jacksonville, IL
Services Provided
Substance abuse , Detoxification
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
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Behavioral Health Services of
(630) 653-4000
27 West 350 High Lake Road
Winfield, IL
Hotline
(630) 653-4000
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

Data Provided by:
Enhanced Clinical Solutions Inc
(708) 344-0884x206
1701 South 1st Avenue
Maywood, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Bridgeway Inc
(309) 734-9461
301 Industrial Park Drive
Monmouth, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Gateway Foundation Inc
(847) 356-8205x3337
25480 West Cedarcrest Lane
Lake Villa, IL
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Liberty Counseling Center
(217) 725-6212
1429 South Main Street
Jacksonville, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

Data Provided by:
Loretto Hospital
(773) 854-5445
645 South Central Avenue
Chicago, IL
Hotline
(800) 592-8120
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Inroads Counseling and DUI Center
(847) 844-1982
150 South Kennedy Drive
Carpentersville, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Community Resource Center
(618) 283-4229
421 West Main Street
Vandalia, IL
Hotline
(618) 533-1391
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
DARU/Domiciliary Addiction
(224) 610-4012
3001 Green Bay Road
North Chicago, IL
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
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

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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