Using Consent Forms San Dimas CA

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.

Valley Christian Center
(626) 335-3917
1404 West Gladstone Street
San Dimas, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
Chinese, Spanish, Tagalog

Data Provided by:
Aurora Behavioral Healthcare
(626) 966-1632
1161 East Covina Boulevard
Covina, CA
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Behavioral Health Services
(909) 865-2336x245
2180 West Valley Boulevard
Pomona, CA
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women, Women, Residential beds for clients' children, Men
Language Services
Spanish, Vietnamese

Data Provided by:
Prototypes
(909) 624-1233
845 East Arrow Highway
Pomona, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Residential beds for clients' children, Criminal justice clients
Language Services
Spanish

Data Provided by:
Ettie Lee Homes Inc
(909) 620-2521
160 East Holt Avenue
Pomona, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Criminal justice clients

Data Provided by:
SPIRITT Family Services
(626) 852-2314
1393 Grand Avenue
Glendora, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
Spanish

Data Provided by:
Pacific Clinics Subst Abuse MH Servs
(626) 335-5980
1160 South Grand Avenue
Glendora, CA
Hotline
(877) 722-2737
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
Language Services
Spanish

Data Provided by:
Pomona Community Crisis Center Inc
(909) 623-1588
240 East Monterey Avenue
Pomona, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
Spanish

Data Provided by:
JJAK Psychotherapy Services Inc
(800) 961-9834
2001 North Garey Avenue
Pomona, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
Spanish

Data Provided by:
Puente House Recovery Services
(800) 494-9844
444 West Badillo Street
Covina, CA
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)

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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