Consent: Rules about Obtaining Consent to Disclose Treatment Information Hattiesburg MS

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Pine Grove Recovery Center
(800) 321-8750
2255 Broadway Drive
Hattiesburg, MS
Hotline
(800) 321-8750x4812
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Clearview Recovery Center of
(601) 544-1499
3 Clearview Circle
Moselle, MS
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
Women, Men

Data Provided by:
Region I Mental Health Center
(662) 326-4445
First Street
Marks, MS
Hotline
(662) 902-7296
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Home of Grace
(228) 826-5283
14200 Jericho Road
Vancleave, MS
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)

Data Provided by:
South Central Regional Medical Center
(601) 426-4000x4336
1220 Jefferson Street
Laurel, MS
Hotline
(601) 426-4381
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient

Data Provided by:
Pine Belt Mental Healthcare Resources
(601) 544-4641
103 South 19th Avenue
Hattiesburg, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Community Counseling Services
(662) 323-9318
302 North Jackson Street
Starkville, MS
Hotline
(800) 890-3127
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Warren/Yazoo Mental Health Service
(601) 638-0031
3444 Wisconsin Avenue
Vicksburg, MS
Hotline
(601) 638-0031
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Weems Community Mental Health Center
(601) 635-3342
90 South 6th Avenue
Decatur, MS
Hotline
(800) 803-0245
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
New Beginnings Res Transitional
(601) 371-7483
2307 McFadden Road
Jackson, MS
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Pregnant/postpartum women, Women, Residential beds for clients' children

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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