Consent: Rules about Obtaining Consent to Disclose Treatment Information Dowagiac MI

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Pokagon Band of Potawatomi Indians
(269) 782-4141x235
57392 M-51 South
Dowagiac, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
Van Buren/Cass District Health Dept
(269) 621-3143x305
57418 County Road 681
Hartford, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Community Healing Centers
(269) 926-0121
777 Riverview Drive
Benton Harbor, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Harbortown Treatment Center PLLC
(269) 926-0015
1022 East Main Street
Benton Harbor, MI
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with HIV/AIDS, Pregnant/postpartum women, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
North Central Health Center
(313) 369-1717
4321 East McNichols Road
Detroit, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Cass County Community Mental Health
(269) 476-9781
17321 M-60 East
Vandalia, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Community Healing Centers
(269) 684-7741
1225 South 11th Street
Niles, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Berrien County Health Department
(269) 926-7135
756 Pipestone Street
Benton Harbor, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
LMAS Addiction Services
(906) 293-5107x304
14150 Hamilton Lake Road
Newberry, MI
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Star Center Inc
(313) 493-4410
13575 Lesure Street
Detroit, MI
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women, 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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