Using Consent Forms Rochester NH

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.

Southeastern New Hampshire Services
(603) 749-3981x204
1 Wakefield Street
Rochester, NH
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Southeastern New Hampshire Services
(603) 749-3981x201
272 County Farm Road
Dover, NH
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Counseling Services Inc
(207) 282-1500
453 U.S. Route 1
Kittery, ME
Hotline
(888) 568-1112
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, DUI/DWI offenders, Criminal justice clients

Data Provided by:
York County Shelter Programs Inc
(207) 324-1137
147 Shaker Hill Road
Alfred, ME
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, Women, Residential beds for clients' children, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Metro Treatment of New Hampshire LP
(603) 622-5005
5 Driving Park Road
Manchester, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient

Data Provided by:
Merrimack River Medical Associates
(603) 953-0077
200 Route 108
Somersworth, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Pregnant/postpartum women, Women, Men, Criminal justice clients
Language Services
Spanish

Data Provided by:
CSI at Springvale Square
(207) 324-1550
474 Main Street
Springvale, ME
Hotline
(888) 568-1112
Services Provided
Substance abuse , Buprenorphine Services
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:
Merrimack River Medical Services
(603) 436-0448
177 Shatuck Way
Newington, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Pregnant/postpartum women, Women

Data Provided by:
York Hospital
(207) 351-2118
15 Hospital Drive
York, ME
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Monadnock Family Services
(603) 357-4400
64 Main Street
Keene, NH
Hotline
(603) 357-4400
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients

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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