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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Koinonia Residential Treatment Center
(800) 864-3009x2100
1991 Winnebago Street
Rhinelander, WI
Hotline
(888) 299-1188
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men, Criminal justice clients

Data Provided by:
Koller Behavioral Health Services
(715) 369-2210
622 Mason Street
Rhinelander, WI
Services Provided
Substance abuse treatment
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:
Eagle River Memorial Hospital
(715) 479-7411
201 Hospital Road
Eagle River, WI
Services Provided
Detoxification
Types of Care
Hospital inpatient

Data Provided by:
Madison Health Services
(608) 242-0220
3113 East Washington Avenue
Madison, WI
Services Provided
Substance abuse treatment, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Women, Men

Data Provided by:
SMART Program
(262) 367-5501
155 East Capitol Drive
Hartland, 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, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Pregnant/postpartum women, Women, Men, DUI/DWI offenders

Data Provided by:
Transitions Center LLC
(715) 365-6696
22 North Pelham Street
Rhinelander, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Koller Behavioral Health Services
(715) 479-4585
150 Hospital Road
Eagle River, WI
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:
La Crosse County Human Services
(608) 785-6101
300 North 4th Street
La Crosse, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

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:
Sauk County Dept of Human Services
(608) 355-4200
505 Broadway Street
Baraboo, WI
Hotline
(800) 533-5692
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

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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