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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Genesis Behavioral Services Inc
(262) 554-7728
4606 Durand Avenue
Racine, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Wheaton Franciscan Health/All Saints
(262) 687-2564
1320 Wisconsin Avenue
Racine, WI
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

Data Provided by:
Racine Psychological Services Inc
(262) 634-8688
840 Lake Avenue
Racine, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Genesis Behavioral Services Inc
(262) 681-3202
4107-4109 Saint Clair Street
Racine, WI
Services Provided
Substance abuse treatment
Types of Care
Residential long-term treatment (more than 30 days)

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:
Lutheran Social Services
(262) 637-3886
2219 Washington Avenue
Racine, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient

Data Provided by:
Genesis Behavioral Services Inc
(262) 633-5001
1654 Washington Avenue
Racine, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Quality Addiction Management (QAM)
(262) 598-1392
6233 Bankers Road
Racine, WI
Services Provided
Substance abuse treatment, Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

Data Provided by:
Aro Behavioral Healthcare Services
(262) 842-0500
3535 30th Avenue
Kenosha, 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:
Aro Counseling Centers Inc
(414) 762-5429
6416 South Howell Avenue
Oak Creek, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, 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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