Consent: Rules about Obtaining Consent to Disclose Treatment Information Sierra Vista 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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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
(520) 458-3932
185 South Moorman Avenue
Sierra Vista, 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

Data Provided by:
Southeastern AZ
(520) 432-7751
1326 Highway 92
Bisbee, AZ
Hotline
(520) 586-9161
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with HIV/AIDS, Pregnant/postpartum women, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Black Family and Child Services of AZ
(602) 243-1773
1522 East Southern Avenue
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients

Data Provided by:
Rainbow Treatment Center
(928) 338-4858
302 West Ponderosa Street
Whiteriver, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Men
Language Services
Apache

Data Provided by:
Arizona Addiction Treatment
(480) 644-9033
525 West Southern Avenue
Mesa, AZ
Services Provided
Substance abuse
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:
Renaissance House
(520) 432-1771
240 O'Hara Avenue
Bisbee, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Residential beds for clients' children

Data Provided by:
Alcoholism Council of Cochise County
(520) 432-3764
936 Tovreaville Road
Bisbee, AZ
Hotline
(520) 432-3764
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men

Data Provided by:
New Arizona Family Inc II
(602) 553-7300x2100
3222 North 37th Street
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Native American Connections Inc
(602) 254-5805
3424 East Van Buren Street
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Pregnant/postpartum women, Women, Residential beds for clients' children

Data Provided by:
Cocopah Alcohol and Drug Abuse
(928) 627-2161
County 15 and Avenue G
Somerton, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
Cocopah, 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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