Consent: Rules about Obtaining Consent to Disclose Treatment Information Lake Havasu City AZ

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

La Frontera Center
(520) 792-0591
1900 West Speedway Boulevard
Tucson, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men

Data Provided by:
West Yavapai Guidance Clinic
(928) 445-5211x299
642 Dameron Drive
Prescott, AZ
Services Provided
Substance abuse , Detoxification
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
Special Programs/Groups
Pregnant/postpartum women, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Hopi, Navajo, Spanish

Data Provided by:
Professional Psychology Associates PC
(602) 852-0911
4222 East Camelback Road
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Compass Healthcare Inc
(520) 620-6615x24
3333 East Grant Road
Tucson, AZ
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, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
New Life Medical Center
(480) 990-3720
617 North Scottsdale Road
Scottsdale, AZ
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Pregnant/postpartum women, Women, Men, Criminal justice clients

Data Provided by:
Sage Holistic Counseling PLC
(520) 888-7243
4735-4737 North First Avenue
Tucson, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Seniors/older adults, Women, Men

Data Provided by:
Centro de Amistad Incorporado
(480) 839-2926
8202 Avenida Del Yaqui
Guadalupe, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Centro de Amistad Inc
(480) 833-0227
460 North Mesa Drive
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Behavioral Health Services
(928) 341-9199
106 East 1st Street
Yuma, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Community Medical Services LLC
(928) 714-0010
2559 East 7th Avenue
Flagstaff, AZ
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

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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