Consent: Rules about Obtaining Consent to Disclose Treatment Information Tullahoma TN

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Cumberland Heights Outpatient of
(931) 455-4272
305 South Jackson Street
Tullahoma, TN
Hotline
(800) 646-9998
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Bradford Health Services
(800) 464-0824
1601 McArthur Street
Manchester, TN
Hotline
(800) 464-0824
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
Comprehensive Community Services
(423) 349-4070
6145 Temple Star Road
Kingsport, TN
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Harbor House Inc
(901) 743-1836x2228
1979 Alcy Road
Memphis, TN
Hotline
(615) 780-5901
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
New Directions Inc
(901) 327-4244
642 Semmes Street
Memphis, TN
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Centerstone Mental Health Centers
(931) 461-1300
1803 North Jackson Street
Tullahoma, TN
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Tony Rice Center Inc
(931) 685-0957
1300 Railroad Avenue
Shelbyville, TN
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Delta Medical Center
(901) 369-6021
3000 Getwell Street
Memphis, TN
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Aspell Recovery Center
(731) 427-7238
331 North Highland Avenue
Jackson, TN
Services Provided
Substance abuse , Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Women, Men

Data Provided by:
Quinco Mental Health Center
(731) 925-5054
1105 Pickwick Road
Savannah, TN
Hotline
(800) 467-2515
Services Provided
Substance abuse
Types of Care
Outpatient
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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