Using Consent Forms Salem 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.

Psychological Center
(978) 685-1337
11 Union Street
Lawrence, MA
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders
Language Services
Spanish

Data Provided by:
Health and Education Services Inc
(978) 373-1126
60 Merrimack Street
Haverhill, MA
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Health and Education Services Inc
(978) 683-3128
30 General Street
Lawrence, MA
Hotline
(978) 620-1250
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
Spanish

Data Provided by:
Quitting Time At Hampstead Hospital
(603) 329-5833
218 East Road
Hampstead, NH
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Lowell House Inc
(978) 459-3371
102 Appleton Street
Lowell, MA
Hotline
(978) 459-8656
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Team Coordinating Agency Inc
(978) 373-1181x10
66-76 Winter Street
Haverhill, MA
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with HIV/AIDS, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
French, Spanish

Data Provided by:
Psychological Center
(978) 687-1658
582-584 Haverhill Street
Lawrence, MA
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Silverman and Associates Inc
(603) 329-6440
2 Village Green Road
Hampstead, NH
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians, Seniors/older adults, Men

Data Provided by:
Merrimack River Medical
(603) 595-3399
323 Derry Road
Hudson, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women, Women, Men
Language Services
Spanish

Data Provided by:
Lowell House Inc
(978) 459-8656
555 Merrimack Street
Lowell, MA
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, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, French, Khmer, Polish, Spanish

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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