Consent: Rules about Obtaining Consent to Disclose Treatment Information South Ozone Park NY

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Faith Mission
(718) 322-3455
114-40 Van Wyck Expressway
South Ozone Park, NY
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Pregnant/postpartum women, Women, Men
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Outreach Outpatient Services (OOS)
(718) 849-6300
117-11 Myrtle Avenue
Richmond Hill, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Seniors/older adults, Women, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Interline Employee Assistance Prog Inc
(718) 206-1368
148-39 Hillside Avenue
Jamaica, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men, DUI/DWI offenders
Language Services
Polish, Russian, Ukrainian

Data Provided by:
Samaritan Village Inc
(718) 441-8913
130-20 89th Road
Richmond Hill, NY
Services Provided
Substance abuse , Detoxification, Methadone Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)

Data Provided by:
Daytop Village Inc
(718) 523-8288
9101 Merrick Boulevard
Jamaica, NY
Hotline
(800) 880-3598
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
820 River Street Inc
(718) 526-3803
14553 South Road
Jamaica, NY
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Samaritan Village Inc
(718) 657-6195
8883 Van Wyck Expressway
Jamaica, NY
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, Persons with HIV/AIDS

Data Provided by:
Mary Immaculate Hospital
(718) 526-0101
14718 Archer Avenue
Jamaica, NY
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women

Data Provided by:
Counseling Services of EDNY
(718) 658-0010
163-18 Jamaica Avenue
Jamaica, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders

Data Provided by:
Alpha School Center for Progresive Liv
(718) 257-5800
2400 Linden Boulevard
Brooklyn, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders, Criminal justice clients

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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