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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

New Arizona Family Inc II
(602) 553-7300x2100
3222 North 37th Street
Phoenix, AZ
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
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Justice Services Inc
(480) 949-8871
7447 East Earll Drive
Scottsdale, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders, Criminal justice clients
Language Services
Spanish

Data Provided by:
Treatment Assessment Screening Ctr Inc
(602) 712-0234x240
1616 East Indian School Road
Phoenix, 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:
Alpha Medical Service
(602) 955-7997
3825 North 24th Street
Phoenix, AZ
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Banner Behavioral Health Hospital
(480) 941-7500
7575 East Earll Drive
Scottsdale, AZ
Hotline
(602) 254-4357
Services Provided
Substance abuse , Detoxification, Methadone Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Professional Psychology Associates PC
(602) 852-0911
4222 East Camelback Road
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
New Arizona Family Inc
(602) 553-7300
2720 East Thomas Road
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Navajo, Spanish

Data Provided by:
Scottsdale Treatment Institute PLC
(480) 429-9044x119
6991 East Camelback Road
Scottsdale, AZ
Hotline
(866) 514-1252
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men, DUI/DWI offenders, Criminal justice clients

Data Provided by:
National Council on Alc/Drug Depend
(602) 264-6214x4
4201 North 16th Street
Phoenix, AZ
Hotline
(866) 836-8078
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Assisted Recovery Centers of America
(602) 264-7897
1000 East Indian School Road
Phoenix, AZ
Hotline
(800) 527-5344
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Gays and Lesbians, DUI/DWI offenders
Language Services
Portugese

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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