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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Behavioral Health Services of
(219) 326-2420
1007 Lincoln Way
La Porte, IN
Hotline
(219) 326-2419
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men

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LaPorte County Comprehensive MH Inc
(219) 879-4621
450 Saint John Road
Michigan City, IN
Hotline
(888) 257-4421
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Center for Problem Resolution Inc
(574) 533-0664
117 West Washington Street
Goshen, IN
Hotline
(574) 533-0664
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Men, DUI/DWI offenders
Language Services
Spanish

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Addiction Recovery Centers Inc
(574) 533-6154
114 North Main Street
Goshen, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Centerstone of Indiana
(317) 834-8187
11370 North SR 67
Mooresville, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Criminal justice clients

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Madison Center Inc
(219) 879-8539
3714 South Franklin Street
Michigan City, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults
Language Services
ASL or other assistance for hearing impaired

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Fort Wayne Womens Bureau Inc
(260) 744-9201
2440 Bowser Avenue
Fort Wayne, IN
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Residential beds for clients' children

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Caring About People Inc
(800) 932-4213
1417 North Anthony Boulevard
Fort Wayne, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
Spanish

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Wabash Valley Hospital Inc
(765) 762-6187
14 Long Avenue
Attica, IN
Hotline
(765) 762-6187
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Valle Vista Health System
(317) 887-1348
898 East Main Street
Greenwood, IN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

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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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