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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

North Central Healthcare Facilities
(715) 848-4600
1100 Lakeview Drive
Wausau, WI
Hotline
(800) 799-0122
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Family Counseling Services of Wausau
(715) 842-3346
903 2nd Street
Wausau, WI
Hotline
(715) 842-3346
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

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:
Aurora Psychiatric Hospital
(414) 454-6600
1220 Dewey Avenue
Wauwatosa, WI
Services Provided
Substance abuse treatment, Detoxification, Methadone Detoxification, Halfway house, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents

Data Provided by:
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:
Wausau Health Services
(715) 845-3637
209 West Washington Street
Wausau, WI
Services Provided
Substance abuse treatment, Methadone Maintenance, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Hmong, Spanish

Data Provided by:
Gateway Recovery
(608) 278-8200
25 Kessel Court
Madison, 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, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Pauquette Center for
(608) 742-5518
2901 Hunters Trail
Portage, WI
Hotline
(608) 742-5344
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Gundersen Lutheran
(608) 775-2287
1910 South Avenue
La Crosse, WI
Hotline
(608) 775-4344
Services Provided
Substance abuse treatment, Detoxification, Methadone Maintenance, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Genesis Detoxification Center
(414) 342-6200
2835 North 32nd Street
Milwaukee, WI
Services Provided
Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less)
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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