Using Consent Forms Middle Village 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.

Elmhurst Hospital Center
(718) 334-3190
7901 Broadway
Flushing, NY
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women
Language Services
Greek, Hebrew, Maltese, 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:
MH Providers of Western Queens Inc
(718) 898-5085
6207 Woodside Avenue
Woodside, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Advanced Human Services Inc
(718) 261-3437
112-15 72ND ROAD
Forest Hills, NY
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, DUI/DWI offenders
Language Services
Polish, Russian, Spanish, Ukrainian

Data Provided by:
Damon House New York Inc
(718) 443-7170
1154-1156 Dekalb Avenue
Brooklyn, NY
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
Spanish

Data Provided by:
Long Island Consultation Center Inc
(718) 896-3400
9729 64th Road
Rego Park, NY
Hotline
(718) 896-3400
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Russian, Spanish

Data Provided by:
Child Center of NY Asian Outreach
(718) 899-9810x200
8708 Justice Avenue
Elmhurst, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
Bengali, Chinese, Farsi, Gujurati, Hindi, Korean, Tagalog, Urdu

Data Provided by:
Community Related Services Inc
(718) 997-1901
9907 Queens Boulevard
Forest Hills, NY
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men, DUI/DWI offenders
Language Services
Farsi, Russian

Data Provided by:
Samaritan Village Inc
(718) 441-8913
130-20 89th Road
Richmond Hill, NY
Services Provided
Substance abuse , Detoxification, Methadone Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)

Data Provided by:
Kingsboro Addiction Treatment Center
(718) 453-3200
754 Lexington Avenue
Brooklyn, NY
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

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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