Consent: Rules about Obtaining Consent to Disclose Treatment Information Keene NH

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Cheshire Medical Center
(603) 354-6670
580 Court Street
Keene, NH
Services Provided
Detoxification
Types of Care
Hospital inpatient

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Phoenix House
(603) 358-4041x6471
106 Roxbury Street
Keene, NH
Services Provided
Substance abuse , Detoxification, Halfway house, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Women, Men
Language Services
French

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Phoenix House of New England
(603) 563-8501x4551
3 Pierce Road
Dublin, NH
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Men

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Brattleboro Retreat
(802) 258-3705
Anna Marsh Lane
Brattleboro, VT
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

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Headrest
(603) 448-4872x211
14 Church Street
Lebanon, NH
Hotline
(603) 448-4400
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
Special Programs/Groups
Adolescents, Seniors/older adults, Women, Criminal justice clients

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Monadnock Family Services
(603) 357-4400
64 Main Street
Keene, NH
Hotline
(603) 357-4400
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients

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Metro Treatment of New Hampshire LP
(603) 358-0070
1076 West Swanzey Road
West Swanzey, NH
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient

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Phoenix Houses of New England
(603) 563-8107x4570
3 Pierce Road
Dublin, NH
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

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NH Div Alcohol/Drug Abuse Prevention
(603) 668-2971
15-17 Brook Street
Manchester, NH
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men

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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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