Consent: Rules about Obtaining Consent to Disclose Treatment Information Buckeye AZ

Most general rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31). To be valid, a consent form must be in writing and must contain each of the items specified in §2.31.

Luke Air Force Base
(623) 856-7579
56 MDOS/SGOMH
Luke AFB, AZ
Services Provided
Substance abuse
Types of Care
Outpatient

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Park Place Outreach and Counseling
(520) 466-8850
9373 West Battaglia Road
Arizona City, AZ
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Residential beds for clients' children, Criminal justice clients

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Pinal County Hispanic Council
(520) 466-7765
712 North Main Street
Eloy, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired, Spanish

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Reflections Family Services Inc
(520) 795-0981
2530 East Broadway Boulevard
Tucson, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
Spanish

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Banner Thunderbird Behavioral Health
(602) 865-5555
5555 West Thunderbird Road
Glendale, AZ
Hotline
(602) 254-4357
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

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Western Judicial Services Inc
(623) 936-8828
9550 West Van Buren Street
Tolleson, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
The Meadows
(928) 684-3926
1655 North Tegner Street
Wickenburg, AZ
Services Provided
Substance abuse , Detoxification, Halfway house, Buprenorphine Services
Types of Care
Hospital inpatient
Language Services
Spanish

Data Provided by:
Rosewood Women''s Center
(800) 845-2211
36075 South Rincon Road
Wickenburg, AZ
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Arizona Addiction Treatment
(480) 644-9033
525 West Southern Avenue
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Center for Behavioral Health
(602) 253-6553
1501 East Washington Street
Phoenix, AZ
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
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Consent: Rules about Obtaining Consent to Disclose Treatment Information

Consent: Rules About Obtaining Consent To Disclose Treatment Information

The most frequently used exception to the regulations’ general rule prohibiting disclosure is client consent. (Parental consent must also be obtained in some States. See below.) The regulations’ requirements regarding consent are strict and somewhat unusual and must be carefully followed.

Most disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31). To be valid, a consent form must be in writing and must contain each of the items specified in §2.31:

1. The name or general description of the program(s) making the disclosure

2. The name or title of the individual or organization that will receive the disclosure

3. The name of the client who is the subject of the disclosure

4. The purpose or need for the disclosure

5. How much and what kind of information will be disclosed

6. A statement that the client may revoke (take back) the consent at any time, except to the extent that the program has already acted on it

7. The date, event, or condition upon which the consent will expire if not previously revoked

8. The signature of the client (and, in some States, his or her parent)

9. The date on which the consent is signed (§2.31(a)).

A general medical release form, or any consent form that does not contain all of the elements listed above, is not acceptable. (See the sample consent form in exhibit 3–1.) ...

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