Using Consent Forms Elkhorn WI

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.

Aro Counseling Centers Inc
(262) 723-1455
797 East Geneva Street
Elkhorn, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, 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:
Kewaunee County Dept of Human Services
(920) 388-7030x270
810 Lincoln Street
Kewaunee, WI
Hotline
(920) 388-7030
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Behavioral Medicine Center
(262) 928-4068
2085 North Calhoun Road
Brookfield, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Coulee Youth Centers Inc
(608) 782-7152
231 Copeland Avenue
La Crosse, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Seniors/older adults, Pregnant/postpartum women, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Racine Psychological Services Inc
(262) 634-8688
840 Lake Avenue
Racine, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Behavioral Medicine Center
(262) 928-4068
240 Maple Avenue
Mukwonago, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Lutheran Social Services
(262) 637-3886
2219 Washington Avenue
Racine, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient

Data Provided by:
Appleton Psychiatric/Counseling Center
(920) 882-6610
477 South Nicolet Road
Appleton, WI
Services Provided
Substance abuse treatment, Detoxification
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Dodge County Department of
(920) 386-3500
199 Home Road
Juneau, WI
Hotline
(920) 386-3500
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Gateway Recovery
(608) 278-8200
25 Kessel Court
Madison, WI
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women
Language Services
ASL or other assistance for hearing impaired

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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