Consent: Rules about Obtaining Consent to Disclose Treatment Information Lafayette IN

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Wabash Valley Hospital Inc
(765) 423-2638
610 Main Street
Lafayette, IN
Hotline
(765) 423-2638
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
New Directions Inc
(765) 589-3318x225
360 North 775 East
Lafayette, IN
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
Men

Data Provided by:
Alpine Counseling Center
(765) 449-9115
3768 Rome Drive
Lafayette, IN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
Russian, Spanish

Data Provided by:
Oaklawn Psychiatric Center Inc
(574) 533-1234
101 Marilyn Avenue
Goshen, IN
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Samaritan Center
(812) 886-6800
400 Main Street
Petersburg, IN
Hotline
(812) 886-6800x1
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Criminal justice clients

Data Provided by:
Building Blocks in Education Inc
(765) 446-7900
2130 Sagamore Parkway North
Lafayette, IN
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Turning Point Counseling Inc
(765) 447-9545
100 Executive Drive
Lafayette, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Anisa Group Lisa B Werth
(765) 497-3932x93
2512 Covington Street
West Lafayette, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients

Data Provided by:
Sisters of Saint Francis Hlth Svs
(219) 865-2141x45008
24 Joliet Street
Dyer, IN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Midwest Addiction Psychiatric and
(260) 471-0632
3010 East State Boulevard
Fort Wayne, IN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, DUI/DWI offenders
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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