Consent: Rules about Obtaining Consent to Disclose Treatment Information Waterloo IA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Covenant Medical Center Horizons
(319) 272-2650
2101 Kimball Avenue
Waterloo, IA
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Cedar Valley Recovery Services
(319) 277-5808
2603 Rainbow Drive
Cedar Falls, IA
Hotline
(319) 240-8911
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
West Des Moines Facility
(515) 280-3860
1211 Vine Street
West Des Moines, IA
Hotline
(515) 280-3860
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
Gays and Lesbians, Women
Language Services
Spanish

Data Provided by:
Unity Healthcare
(563) 264-9409
1605 Cedar Street
Muscatine, IA
Hotline
(563) 264-9409
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Ellsworth Municipal Hospital
(641) 648-6491
520 Talbott Street
Iowa Falls, IA
Hotline
(641) 648-6491
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Pathways Behavioral Services Inc
(319) 232-5363
500 East 4th Street
Waterloo, IA
Hotline
(319) 235-6571
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Gilbert Alber PC
(563) 547-1779
110 North Park Place
Cresco, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Center for Addiction Recovery Inc
(515) 433-0369
806 7th Street
Boone, IA
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment

Data Provided by:
New Opportunities Inc
(641) 747-3354
411 State Street
Guthrie Center, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Prairie Ridge
(641) 424-2391
320 North Eisenhower Avenue
Mason City, IA
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, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Men, DUI/DWI offenders, Criminal justice clients
Language Services
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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