Consent: Rules about Obtaining Consent to Disclose Treatment Information Burlingame CA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

Women''s Recovery Association
(650) 348-6603
1450 Chapin Avenue
Burlingame, CA
Hotline
(650) 348-6603x0
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Mills Peninsula Health Services
(650) 696-5363
1783 El Camino Real
Burlingame, CA
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults

Data Provided by:
Project Intermission House
(650) 579-7881
114 South Delaware Street
San Mateo, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Solidarity Fellowship Inc
(650) 341-3803
1679 South Norfolk Street
San Mateo, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Criminal justice clients

Data Provided by:
Latino Commission on Alc/DA Services
(650) 244-1444
693 7th Avenue
San Bruno, CA
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men
Language Services
Spanish

Data Provided by:
SD Consulting Services
(650) 222-6134
1220 Howard Avenue
Burlingame, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
Project Ninety Inc
(650) 348-9714
31 9th Avenue
San Mateo, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Women''s Recovery Association
(650) 347-8808
900 Laurel Avenue
San Mateo, CA
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired, Chinese, Spanish

Data Provided by:
Palm Avenue Detox/Horizons Servs Inc
(650) 513-6500
2251 Palm Avenue
San Mateo, CA
Services Provided
Detoxification
Types of Care
Residential short-term treatment (30 days or less)
Language Services
Arabic, Spanish

Data Provided by:
Kaiser Permanente Medical Center
(650) 616-6200
1001 Sneath Lane
San Bruno, CA
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Women, Men
Language Services
Spanish

Data Provided by:
Data Provided by:

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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