Consent: Rules about Obtaining Consent to Disclose Treatment Information Janesville WI

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Mercy Options
(608) 756-6545
1000 Mineral Point
Janesville, WI
Services Provided
Substance abuse treatment, 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

Data Provided by:
Rock Valley Community Programs Inc
(608) 741-4500
203 West Sunny Lane Road
Janesville, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Criminal justice clients

Data Provided by:
Alcocare Inc
(608) 754-2651
786 South Main Street
Janesville, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Tellurian UCAN Inc
(608) 365-6600
74 Eclipse Center
Beloit, WI
Hotline
(608) 757-5025x0
Services Provided
Substance abuse treatment
Types of Care
Outpatient

Data Provided by:
Mercy Options
(608) 365-2709
2825 Prairie Avenue
Beloit, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient

Data Provided by:
Alcocare Inc
(608) 754-2651
430 North Jackson Street
Janesville, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Crossroads Counseling Center
(608) 755-5260
17 South River Street
Janesville, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

Data Provided by:
Lutheran Social Services
(608) 752-7660
612 North Randall Avenue
Janesville, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Quality Addiction Management


Services Provided
Substance abuse treatment, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

Data Provided by:
Beloit Memorial Hospital
(608) 364-5686
1969 West Hart Road
Beloit, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

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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