Consent: Rules about Obtaining Consent to Disclose Treatment Information Dayton OH

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Nova House Association Inc
(937) 253-1680x211
732 Beckman Street
Dayton, OH
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Miami Valley Hospital
(937) 208-4673
627 Edwin C Moses Boulevard
Dayton, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Day Mont Behavioral Healthcare Inc
(937) 222-8111x355
1520 Germantown Street
Dayton, OH
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, French

Data Provided by:
Dayton VA Medical Center
(937) 268-6511x1314
4100 West 3rd Street
Dayton, OH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Men
Language Services
Spanish

Data Provided by:
South Community Inc
(937) 293-8300
3095 Kettering Boulevard
Dayton, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women

Data Provided by:
Center for Alcoholism and Drug
(937) 461-5223
1 Elizabeth Place SE
Dayton, OH
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Public Health Dayton and Montgomery Co
(937) 461-5223x3017
One Elizabeth Place
Dayton, OH
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Adolescents, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Eastway Corporation
(937) 463-2955x3151
1110 Webster Street
Dayton, OH
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

Data Provided by:
Day Mont Behavioral Healthcare Inc
(937) 461-6630
221 Alliance Place
Dayton, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Integrated Youth Services
(937) 427-3837x222
1321 Research Park Drive
Beavercreek, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

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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