Using Consent Forms Dunkirk NY

When a rehab program that offers assessment and treatment for substance abuse asks a family member (including a parent), partner, employer, school, or doctor to verify information it has obtained from the client, it is making a disclosure that the client has sought help for substance abuse.

Chautauqua County Department of
(716) 363-3550
319 Central Avenue
Dunkirk, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Cattaraugus Indian Reservation Health
(716) 532-5583
36 Thomas Indian School Drive
Irving, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Hamilton-Madison House
(212) 720-4520
253 South Street
New York, NY
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Language Services
Chinese, Japanese, Korean

Data Provided by:
Mount Vernon Hospital
(914) 631-6239x7242
3 South 6th Avenue
Mount Vernon, NY
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Pregnant/postpartum women, Women
Language Services
Spanish

Data Provided by:
City Hospital Center at Elmhurst (CHC)
(718) 334-4660
8130 Baxter Avenue
Elmhurst, NY
Hotline
(718) 334-4000
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
TLC Health Tri County
(716) 595-3355x1206
33 North Main Street
Cassadaga, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women

Data Provided by:
TLC Hlth Net Tri County Memorial Hosp
(716) 532-8900x8749
100 Memorial Drive
Gowanda, NY
Services Provided
Substance abuse , Buprenorphine Services
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, Pregnant/postpartum women, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
South Brooklyn Medical Admin Services
(718) 788-2594
685 3rd Avenue
Brooklyn, NY
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Language Services
Arabic, Russian, Spanish

Data Provided by:
Veterans Affairs Medical Center
(718) 584-9000x6958
130 West Kingsbridge Road
Bronx, NY
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Seniors/older adults, Women, Men
Language Services
Spanish

Data Provided by:
Queens Hospital Center (HHC)
(718) 883-2750
8268 164th Street
Jamaica, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Data Provided by:

Using Consent Forms

Using Consent Forms

The fact that a client has signed a valid consent form authorizing the release of information does not mean that a program must make the proposed disclosure, unless the program has also received a subpoena or court order (§§2.3(b)(1); 2.61(a)(b)). In most cases, the decision whether to make a disclosure authorized by a client’s signed consent is up to the program, unless State law requires or prohibits a particular disclosure once consent is given. The program’s only obligation under the Federal regulations is to refuse to honor a consent that is expired, deficient, or otherwise known to be revoked, false, or incorrect (§2.31(c)).

In general, it is best to follow this rule: Disclose only what is necessary, for only as long as is necessary, keeping in mind the purpose for disclosing the information.

Using consent forms to seek information from collateral sources

Making inquiries of families, partners, schools, employers, doctors, and other health care providers might, at first glance, seem to pose no risk to a client’s right to confidentiality. But it does.

When a program that offers assessment and treatment for substance abuse asks a family member (including a parent), partner, employer, school, or doctor to verify information it has obtained from the client, it is making a disclosure that the client has sought help for substance abuse. The Federal regulations generally prohibit this kind of disclosure unless the clie...

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