Consent: Rules about Obtaining Consent to Disclose Treatment Information Pine Bluff AR

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Human Development and Research Servs
(870) 535-3535
2106 East 6th Street
Pine Bluff, AR
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:
Decision Point Inc
(479) 756-1060
301 Holcomb Street
Springdale, AR
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Quapaw House Inc
(870) 246-7636
401 Crittenden Street
Arkadelphia, AR
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Veterans Affairs Medical Center
(479) 444-5048
1100 North College Street
Fayetteville, AR
Hotline
(800) 273-8255
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment

Data Provided by:
Ouachita Medical Center
(870) 836-1289
638 California Street
Camden, AR
Hotline
(800) 232-1289
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Human Development and Research Servs
(870) 879-1051
6841 West 13th Street
Pine Bluff, AR
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Counseling Clinic Inc
(501) 315-4224x536
307 East Sevier Street
Benton, AR
Hotline
(501) 315-4224
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
NADC Substance Abuse Treatment Program
(870) 793-2221
Oak and 9th Streets
Batesville, AR
Services Provided
Substance abuse
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:
Counseling Associates Inc
(479) 968-1298
110 Skyline Drive
Russellville, AR
Hotline
(800) 844-2066
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish, Vietnamese

Data Provided by:
Recover at Baptist Health
(501) 202-4636
9601 Interstate 630
Little Rock, AR
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment

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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