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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

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:
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:
Mississippi State Hospital
(601) 351-8000x4929
3550 Highway 468 West
Whitfield, MS
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient
Special Programs/Groups
Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
East Mississippi State Hospital
(601) 482-6186x11243
4555 Highland Park Drive
Meridian, MS
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient
Special Programs/Groups
Men

Data Provided by:
Pines and Cady Hills Chemical
(662) 327-7916
1011 Main Street
Columbus, MS
Hotline
(662) 328-0200
Services Provided
Substance abuse , Detoxification
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, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Singing River Services
(228) 497-0690
3407 Shamrock Court
Gautier, MS
Hotline
(228) 497-0690
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
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:
Life Help
(662) 283-2529
718 Alberta Drive
Winona, MS
Hotline
(866) 453-6216
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment

Data Provided by:
Parkwood Behavioral Health System
(662) 895-4900
8135 Goodman Road
Olive Branch, MS
Hotline
(662) 893-7065
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Language Services
ASL or other assistance for hearing impaired

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:
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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