Consent: Rules about Obtaining Consent to Disclose Treatment Information Mukwonago WI

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Behavioral Medicine Center
(262) 928-4068
240 Maple Avenue
Mukwonago, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Southeastern Youth/Family Services Inc
(262) 549-6638
West 222 South 3210 Racine Avenue
Waukesha, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents

Data Provided by:
Lutheran Social Services
(262) 542-2663
325 Sentinel Drive
Waukesha, WI
Services Provided
Substance abuse treatment, 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:
Behavioral Medicine Center
(262) 928-4068
721 American Avenue
Waukesha, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Aro Counseling Centers Inc
(262) 367-5104
2314 North Grandview Bouldvard
Waukesha, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
La Casa de Esperanza
(262) 928-4402
210 NW Barstow Street
Waukesha, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Men, DUI/DWI offenders, Criminal justice clients
Language Services
French, German, Italian, Polish, Spanish, Vietnamese

Data Provided by:
Behavioral Medicine Center
(262) 928-6900
3011 Saylesville Road
Waukesha, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Residential short-term treatment (30 days or less), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Women, Men

Data Provided by:
Genesis House
(262) 544-0711
1002 Motor Avenue
Waukesha, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men

Data Provided by:
Century House
(262) 544-6233
1130 Northview Road
Waukesha, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Quality Addiction Management (QAM)
(262) 549-6600
2422 North Grandview Boulevard
Waukesha, WI
Services Provided
Substance abuse treatment, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

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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