Consent: Rules about Obtaining Consent to Disclose Treatment Information Mesa AZ

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Community Bridges Inc
(480) 962-7922
554 South Bellview Street
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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Treatment Assessment Screening Ctr Inc
(480) 898-1849
423 North Country Club Drive
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Catholic Social Serivce
(480) 964-8771
430 North Dobson Road
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
Spanish

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Arizona Addiction Treatment
(480) 644-9033
525 West Southern Avenue
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Parc Place
(480) 917-9301
2190 North Grace Boulevard
Chandler, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
New Hope Behavioral Health Center Inc
(480) 981-1022
215 South Power Road
Mesa, AZ
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Pregnant/postpartum women, Women, Men

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Centro de Amistad Inc
(480) 833-0227
460 North Mesa Drive
Mesa, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Women in New Recovery
(480) 464-5764
860 North Center Street
Mesa, AZ
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Women, Residential beds for clients' children

Data Provided by:
House for Acceptance
(480) 844-1306
143 South Center Street
Mesa, AZ
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
Spanish

Data Provided by:
Chandler Valley Hope Alcohol/Drug and
(480) 899-3335
501 North Washington Street
Chandler, AZ
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

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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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