Consent: Rules about Obtaining Consent to Disclose Treatment Information Kernersville NC

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Addiction Recovery Care Association
(336) 784-9470x15
1931 Union Cross Road
Winston Salem, NC
Hotline
(336) 784-9470
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less)

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Friendship Vision House
(336) 722-9709
533 Summit Street
Winston Salem, NC
Services Provided
Halfway house

Data Provided by:
Daymark Recovery Services
(336) 607-8523
725 North Highland Avenue
Winston Salem, NC
Hotline
(866) 275-9552
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Youth Focus
(336) 333-6853x242
5016 West Friendly Avenue
Greensboro, NC
Hotline
(336) 312-3373
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
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:
Alcohol and Drug Services
(336) 882-2125
119 Chestnut Drive
High Point, NC
Hotline
(866) 449-8368
Services Provided
Substance abuse , Methadone Maintenance, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Psycare of Triad
(336) 774-3988
122 North Spruce Street
Winston Salem, NC
Services Provided
Substance abuse
Types of Care
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:
Twin City Counseling Center
(336) 722-9592
523 Summit Street
Winston Salem, NC
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Insight Human Services
(336) 725-8389
665 West 4th Street
Winston Salem, NC
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women, Women, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Incentives Inc
(336) 841-1104
1026 Hutton Lane
High Point, NC
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Alcoholics Home Inc
(336) 882-1026
5884 Riverdale Drive
Jamestown, NC
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)

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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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