Consent: Rules about Obtaining Consent to Disclose Treatment Information North Pole AK

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Fort Wainwright Community Counseling
(907) 353-6059
Building 4066
Fort Wainwright, AK
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Project Special Delivery
(907) 452-4222
710 3rd Avenue
Fairbanks, AK
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

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Tanana Chiefs Conference Inc
(907) 452-8251
122 1st Avenue
Fairbanks, AK
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
Persons with co-occurring mental and substance abuse disorders, Residential beds for clients' children

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Graf Rheeneenhaanjii
(907) 455-4725
2550 Lawlor Road
Fairbanks, AK
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents

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North Slope Borough Dept of Hlth Soc
(907) 852-0366
5200 Karluk Street
Barrow, AK
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
Inupiat

Data Provided by:
Interior AIDS Association
(907) 452-4222
710 3rd Avenue
Fairbanks, AK
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient

Data Provided by:
Ralph Perdue Center
(907) 452-6251x211
3100 South Cushman Street
Fairbanks, AK
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), Outpatient

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Women''s and Children''s Center for
(907) 451-8164
1027 Evergreen Street
Fairbanks, AK
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Residential beds for clients' children
Language Services
ASL or other assistance for hearing impaired

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ASAP Counseling Center
(907) 384-7368
600 Richardson Drive
Fort Richardson, AK
Services Provided
Substance abuse
Types of Care
Outpatient

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Salvation Army
(907) 276-2898
1709 Bragaw Street
Anchorage, AK
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

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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