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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

University of IA Hospitals and Clinics
(319) 384-8765
200 Hawkins Drive
Iowa City, IA
Services Provided
Substance abuse
Types of Care
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

Data Provided by:
Ottumwa Regional Health Center
(641) 684-3170
312 East Alta Vista Avenue
Ottumwa, IA
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, DUI/DWI offenders

Data Provided by:
First Step Mercy Recovery Center
(515) 271-6075
1818 48th Street
Des Moines, IA
Hotline
(515) 271-6111
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
New Opportunities Inc
(515) 386-4795
1000 West Lincolnway
Jefferson, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Alcohol and Drug Dependency Services
(319) 753-6567
1340 Mount Pleasant Street
Burlington, 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, DUI/DWI offenders, Criminal justice clients
Language Services
Russian, Spanish

Data Provided by:
Mid Eastern Council on Chemical Abuse
(319) 351-4357
430 Southgate Avenue
Iowa City, IA
Hotline
(319) 351-4357
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), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired, Spanish

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:
Northwest Iowa Alcoholism and
(712) 262-2952
1201 South 2nd Avenue
Sheldon, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
New Opportunities Substance Abuse
(712) 563-2777
413 Tracy Street
Audubon, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
Spanish

Data Provided by:
Community and Family Resources
(515) 832-5432
509 Division Street
Webster City, IA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

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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