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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Saint Joseph''s Hospital
(800) 468-9700
611 Saint Joseph Avenue
Marshfield, WI
Hotline
(800) 468-9700
Services Provided
Substance abuse treatment, 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, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Lafayette County
(608) 776-4800
627 Main Street
Darlington, WI
Hotline
(608) 776-4848
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Behavioral Medicine Center
(262) 928-4068
240 Maple Avenue
Mukwonago, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Behavioral Medicine Center
(262) 928-4036
13900 West National Avenue
New Berlin, 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:
Interconnections SC
(262) 654-5333
920 60th Street
Kenosha, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient

Data Provided by:
Family Resource Center
(715) 588-1511
533 Peace Pipe Road
Lac Du Flambeau, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Wausau Health Services
(715) 845-3637
209 West Washington Street
Wausau, WI
Services Provided
Substance abuse treatment, Methadone Maintenance, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Hmong, Spanish

Data Provided by:
Riverside Medical Center Behav Health
(715) 258-8459
190 Grand Seasons Drive
Waupaca, WI
Hotline
(715) 344-4611
Services Provided
Substance abuse treatment
Types of Care
Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Theda Care Behavioral Health at
(920) 729-2145
130 2nd Street
Neenah, WI
Services Provided
Detoxification
Types of Care
Hospital inpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
HRC
(715) 392-8216
1500 North 34th Street
Superior, WI
Hotline
(715) 395-2259
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women
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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