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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Arbor Place Inc
(715) 235-4537x106
320 21st Street NE
Menomonie, WI
Services Provided
Substance abuse treatment, 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, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Marinette County Hlth and Human Servs
(715) 732-7760
2500 Hall Avenue
Marinette, WI
Hotline
(715) 732-7768
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Pauquette Center for
(608) 742-5518
2901 Hunters Trail
Portage, WI
Hotline
(608) 742-5344
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Nova Counseling Services Inc
(920) 231-0143
3240 Jackson Street
Oshkosh, WI
Services Provided
Substance abuse treatment, 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
Women, Men

Data Provided by:
Counseling and Development Center Inc
(715) 339-3048
171 Chestnut Street
Phillips, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Mental Health Center of Dane County
(608) 280-2520
625 West Washington Avenue
Madison, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Hindi, Hmong, Spanish

Data Provided by:
Oakwood Clinical Associates
(262) 652-9830
24726 75th Street
Paddock Lake, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders

Data Provided by:
Lutheran Social Services
(920) 225-1713
820 West College Avenue
Appleton, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Seniors/older adults

Data Provided by:
Recovery Network
(414) 647-9930
1314 West National Avenue
Milwaukee, WI
Services Provided
Substance abuse treatment, 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
Adolescents
Language Services
Spanish

Data Provided by:
Langlade Healthcare Center
(715) 627-6694
1225 Langlade Road
Antigo, WI
Hotline
(800) 799-0122
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
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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