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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

MARCO Services Inc
(920) 684-0605
1114 South 11th Street
Manitowoc, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Jackie Nitschke Center Inc
(920) 435-2093
700 Cherry Street
Green Bay, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Hoffe Counseling Inc
(608) 796-1168
319 Main Street
La Crosse, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
La Crosse County Human Services
(608) 785-6101
300 North 4th Street
La Crosse, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Behavioral Medicine Center
(262) 928-4036
1185 Corporate Center Drive
Oconomowoc, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Connections Counseling
(608) 221-1500x11
1334 Applegate Road
Madison, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders

Data Provided by:
Poynette Counseling and
(608) 635-2146
415 North Main Street
Poynette, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient

Data Provided by:
Clark County Community Services
(715) 743-5204
517 Court Street
Neillsville, WI
Hotline
(800) 863-3560
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Beacon House
(920) 923-3999
166 South Park Avenue
Fond Du Lac, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Residential beds for clients' children

Data Provided by:
Bellin Psychiatric Center
(920) 431-5533
301 East Saint Joseph Street
Green Bay, WI
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

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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