Consent: Rules about Obtaining Consent to Disclose Treatment Information Cedar Falls IA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Cedar Valley Recovery Services
(319) 277-5808
2603 Rainbow Drive
Cedar Falls, IA
Hotline
(319) 240-8911
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Covenant Medical Center Horizons
(319) 272-2650
2101 Kimball Avenue
Waterloo, IA
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
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
House of Mercy
(515) 643-6500
1409 Clark Street
Des Moines, IA
Services Provided
Substance abuse , 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, Women, Residential beds for clients' children

Data Provided by:
Alcohol and Drug Dependency Servs of
(319) 385-2216
122 North Main Street
Mount Pleasant, IA
Hotline
(319) 385-2216
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Pregnant/postpartum women, DUI/DWI offenders

Data Provided by:
Youth and Shelter Services
(515) 233-3141
420 Kellogg Avenue
Ames, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Pathways Behavioral Services Inc
(319) 232-5363
500 East 4th Street
Waterloo, IA
Hotline
(319) 235-6571
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Zion Recovery Services
(712) 542-3720
1800 North 16
Clarinda, IA
Hotline
(641) 337-5385
Services Provided
Substance abuse , Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men

Data Provided by:
Northwest Iowa Alcoholism and
(712) 439-1170
1126 Main Street
Hull, IA
Hotline
(712) 262-2952
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Madison County Memorial Hospital
(515) 462-3105
1223 E Buchanan
Winterset, IA
Hotline
(515) 462-2373
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Northwest Iowa Alcoholism and
(712) 336-5281
710 Lake Street
Spirit Lake, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

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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