Consent: Rules about Obtaining Consent to Disclose Treatment Information Oak Forest IL

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Bremen Youth Services
(708) 687-9200
15350 Oak Park Avenue
Oak Forest, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

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New Visions Counseling Services Inc
(630) 493-1100
7808 West College Drive
Palos Heights, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Guildhaus Halfway House
(708) 385-3228
2413 West Canal Street
Blue Island, IL
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men

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A Safe Haven
(708) 389-6450
12535 South Central Street
Alsip, IL
Hotline
(312) 372-6707
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Residential beds for clients' children

Data Provided by:
Family Guidance Centers Inc
(708) 333-8960
15400 South Page Avenue
Harvey, IL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient

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Palos Community Hospital
(708) 923-4000x5775
12251 South 80th Avenue
Palos Heights, IL
Hotline
(708) 361-8255
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults

Data Provided by:
Ingalls Memorial Hospital Department
(708) 333-2300
1 Ingalls Drive
Harvey, IL
Hotline
(800) 543-6453
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Primary Care Center
(708) 460-2370
15300 West Avenue
Orland Park, IL
Hotline
(708) 361-8255
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Associates in Alcohol and
(708) 349-2654
62 Orland Square Drive
Orland Park, IL
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
Spanish

Data Provided by:
Link and Option Center
(708) 331-4880
15652 Homan Avenue
Markham, IL
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men, Criminal justice clients

Data Provided by:
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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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