Consent: Rules about Obtaining Consent to Disclose Treatment Information Fremont 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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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.

Carnales Unidos Reformando Adictos
(510) 713-3202
37437 Glenmoor Drive
Fremont, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
Spanish

Data Provided by:
Second Chance Newark Center
(510) 792-4357
6330 Thornton Avenue
Newark, CA
Hotline
(510) 792-4357
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Fremont Hospital
(510) 796-1100
39001 Sundale Drive
Fremont, CA
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired, Chinese, Spanish, Tagalog

Data Provided by:
Managed Health Network
(510) 430-3699
2847 Whipple Road
Union City, CA
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient
Special Programs/Groups
Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Terra Firma Diversion
(510) 675-9362
30086 Mission Boulevard
Hayward, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
Spanish

Data Provided by:
Second Chance
(510) 792-4357
4673 Thorton Avenue
Fremont, CA
Hotline
(510) 792-4357
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Pregnant/postpartum women, Women
Language Services
Spanish

Data Provided by:
Community Counseling and
(510) 792-4964
3775 Beacon Avenue
Fremont, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Solidarity Fellowship Inc
(510) 796-7120
34401 and 34413 Blackstone Way
Fremont, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men, Criminal justice clients

Data Provided by:
Kaiser Permanente
(510) 675-3080
3551 Whipple Road
Union City, CA
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women
Language Services
Spanish

Data Provided by:
Successful Alternatives for
(510) 247-8300
795 Fletcher Lane
Hayward, CA
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Criminal justice clients
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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