Consent: Rules about Obtaining Consent to Disclose Treatment Information Kokomo IN

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Kokomo Living Life Clean LLC
(317) 695-8576
122 West Walnut Street
Kokomo, IN
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Four County Counseling Center
(574) 722-5151
655 East Main Street
Peru, IN
Hotline
(800) 552-3106
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
GR George and Associates Inc
(317) 883-4749
2801 Fairview Place
Greenwood, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Grant Blackford Mental Health Inc
(765) 662-2039
116 East 32nd Street
Marion, IN
Hotline
(765) 662-3971
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:
Samaritan Center
(812) 886-6800
400 Main Street
Petersburg, IN
Hotline
(812) 886-6800x1
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Criminal justice clients

Data Provided by:
Saint Joseph Hospital and Health Ctr
(765) 456-5900
1907 West Sycamore Street
Kokomo, IN
Hotline
(800) 638-7844
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
LifeSpring Inc
(812) 738-2114
535 Country Club Road
Corydon, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients

Data Provided by:
Madison Center Inc
(574) 280-4655
801 East Washington Street
South Bend, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Gays and Lesbians
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Community Hospitals of Indiana Inc
(317) 621-5700
7150 Clearvista Drive
Indianapolis, IN
Hotline
(317) 621-5700
Services Provided
Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Centerstone of Indiana
(317) 834-8187
11370 North SR 67
Mooresville, IN
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Criminal justice clients

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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