Using Consent Forms Eden NC

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.

Life Changes Counseling
(336) 623-8584
7586 NC 770 West
Eden, NC
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Rockingham County Mental Health
(336) 342-8316
405 NC 65
Wentworth, NC
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Passages
(276) 632-5685
817 Starling Avenue
Martinsville, VA
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Men

Data Provided by:
Associates in Mental Health Servs PC
(434) 791-2059
108 Holbrook Street
Danville, VA
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
McLeod Addictive Disease Center Inc
(704) 865-1558
549 Cox Road
Gastonia, NC
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient

Data Provided by:
Employee Counseling Associates Inc
(336) 627-4532
407 South Van Buren Road
Eden, NC
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Memorial Hospital of Martinsville and
(276) 666-7200
320 Hospital Drive
Martinsville, VA
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient

Data Provided by:
Piedmont Community Services
(276) 632-7128
24 Clay Street
Martinsville, VA
Hotline
(276) 632-7295
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, Criminal justice clients

Data Provided by:
Alcoholic Counseling Services Inc
(434) 793-9806
1021 Main Street
Danville, VA
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)
Special Programs/Groups
Men

Data Provided by:
Healthplus Therapeutic Services
(252) 948-0333x206
1710 North Carolina Avenue
Washington, NC
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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