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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

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:
Bradford Health Services
(800) 333-0906
1000 Hillcrest Road
Mobile, AL
Hotline
(251) 633-0900
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Gulf Coast Treatment Center
(251) 865-0123
12271 Interchange Road
Grand Bay, AL
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
North Mississippi Medical Center
(662) 377-3161
4579 South Eason Street
Tupelo, MS
Hotline
(800) 442-2238
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Life Help
(662) 455-3222
2801 Highway 82 East
Greenwood, MS
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Bridge Inc
(251) 633-0475
3401 Newman Road
Mobile, AL
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Stevens Center of Singing River Servs
(228) 769-1280
4905 Telephone Road
Pascagoula, MS
Hotline
(228) 497-0690
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)

Data Provided by:
Life Help
(662) 289-4735
314 South Huntington Street
Kosciusko, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Saint Dominic Behavioral Health Servs
(601) 200-3090x3198
969 Lakeland Drive
Jackson, MS
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Common Bond Association Inc
(601) 371-6851
836 Medical Plaza
Jackson, MS
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)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Men, 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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