Consent: Rules about Obtaining Consent to Disclose Treatment Information South Haven MI

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Van Buren/Cass District Health Dept
(269) 621-3143x305
57418 County Road 681
Hartford, MI
Services Provided
Substance abuse
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:
Mercy Memorial Hospital
(734) 240-1760
700 Stewart Road
Monroe, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Bay Area Substance Education Servs Inc
(231) 547-1144
208 West Lincoln Street
Charlevoix, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders

Data Provided by:
Eastwood Clinics
(313) 583-0735
5111 Auto Club Drive
Dearborn, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Sacred Heart Rehabilitation Center Inc
(586) 749-5173
58144 Gratiot Avenue
New Haven, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
List Psychological Services PLC
(810) 667-4500
350 North Court Street
Lapeer, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Complete Counseling Center Inc
(517) 546-4445
721 East Grand River Avenue
Howell, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Catholic Social Services of
(313) 792-9286
20382 Van Born Road
Dearborn Heights, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Seniors/older adults, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Proaction Behavioral Health Alliance
(616) 776-0891x401
822 Cherry Street SE
Grand Rapids, MI
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Salvation Army Harbor Light Center
(734) 242-5050
3580 South Custer Road
Monroe, MI
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
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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