Consent: Rules about Obtaining Consent to Disclose Treatment Information Jamestown 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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

WCA Hospital
(716) 664-8641
51 Glasgow Avenue
Jamestown, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, Criminal justice clients

Data Provided by:
TLC Health Tri County
(716) 595-3355x1206
33 North Main Street
Cassadaga, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women

Data Provided by:
Suffolk County Dept of Health Services
(631) 852-2680
300 Center Drive
Riverhead, NY
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
Spanish

Data Provided by:
Bridge Back to Life Center Inc
(516) 520-6600
4271 Hempstead Turnpike
Bethpage, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders

Data Provided by:
Staten Island YMCA Counseling Services
(718) 948-3232
3911 Richmond Avenue
Staten Island, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Chautauqua County Department of MH
(716) 661-8330x8374
200 East 3rd Street
Jamestown, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients

Data Provided by:
Deerfield Centers for Addictions Trt
(814) 723-8120
513 West 3rd Street
Warren, PA
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Hamilton-Madison House
(212) 720-4520
253 South Street
New York, NY
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Language Services
Chinese, Japanese, Korean

Data Provided by:
Daytop Village Inc
(845) 292-6880
Route 55
Swan Lake, NY
Hotline
(800) 232-9867
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men
Language Services
Spanish

Data Provided by:
United Bronx Parents Inc UBP
(718) 292-9808
1006 East 151st Street
Bronx, NY
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Residential beds for clients' children
Language Services
Spanish

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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