Consent: Rules about Obtaining Consent to Disclose Treatment Information Safford AZ

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Southeastern AZ
(928) 428-4550
1615 South 1st Street
Safford, AZ
Hotline
(800) 586-9161
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Pregnant/postpartum women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

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Arizona Treatment Institute LLC
(520) 836-9788
1927 North Trekell Road
Casa Grande, AZ
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

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Maverick House
(623) 931-5810
7022 North 48th Avenue
Glendale, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Language Services
ASL or other assistance for hearing impaired

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The Mark Youth and Family Care
(520) 326-6182
4653 East Pima Street
Tucson, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
Spanish

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Sage Holistic Counseling PLC
(520) 888-7243
4735-4737 North First Avenue
Tucson, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Seniors/older adults, Women, Men

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Tempe Valley Hope Outpatient
(480) 831-9533
2115 East Southern Avenue
Tempe, AZ
Services Provided
Substance abuse
Types of Care
Outpatient

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Yavapai Apache Nation
(928) 567-3977
3462 Smith Avenue
Camp Verde, AZ
Hotline
(928) 301-0322
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

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Addiction Resources Inc
(602) 233-9401
4337 West Indian School Road
Phoenix, AZ
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women, Women
Language Services
German, Spanish

Data Provided by:
Mountain Valley and Associates Inc
(602) 870-0972
2432 West Peoria Avenue
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients

Data Provided by:
Professional Psychology Associates PC
(602) 852-0911
4222 East Camelback Road
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

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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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