Using Consent Forms Galion OH

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.

Mansfield Urban Minority Alc and
(419) 525-3525
400 Bowman Street
Mansfield, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
New Beginnings Recovery Services
(419) 526-6168
270 Sterkel Boulevard
Mansfield, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Pregnant/postpartum women, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Foundation For Living
(419) 589-5511x212
1451 Lucas Road
Mansfield, OH
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Saint Thomas Hospital
(330) 379-9841
444 North Main Street
Akron, OH
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Saint Rita''s Medical Center
(419) 226-9029
730 West Market Street
Lima, OH
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Cornell Abraxas Group Inc
(419) 747-3322
2775 State Route 39
Shelby, OH
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Criminal justice clients

Data Provided by:
Center for Individual and
(419) 756-1717
741 Scholl Road
Mansfield, OH
Hotline
(419) 522-4357
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Jefferson Behavioral Health System
(740) 284-7165
200 North 4th Street
Steubenville, OH
Hotline
(740) 264-1627
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

Data Provided by:
First Step Home Inc
(513) 961-4663
2203 Fulton Avenue
Cincinnati, OH
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Pregnant/postpartum women, Residential beds for clients' children

Data Provided by:
Harbor Light
(216) 781-3773x143
1710 Prospect Avenue
Cleveland, OH
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Language Services
Chinese, Korean, Polish, Spanish, Vietnamese

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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