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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Intensive Treatment Systems LLC
(602) 996-0099
19401 North Cave Creek Road
Phoenix, AZ
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Language Services
Spanish

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Native American Connections Inc
(602) 424-2060
4520 North Central Avenue
Phoenix, AZ
Services Provided
Substance abuse , Halfway house
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired, Hopi, Lakota, Navajo, Pima, Spanish

Data Provided by:
Central Counseling and
(602) 235-9237
49 East Thomas Road
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Calvary Center
(602) 279-1468
720 East Montebello Avenue
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)

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Terros Inc
(602) 685-6000
3864 North 27th Avenue
Phoenix, AZ
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Arabic, Spanish

Data Provided by:
Intensive Treatment Systems Inc
(602) 248-0550
651 West Coolidge Street
Phoenix, AZ
Services Provided
Substance abuse , Methadone Maintenance
Types of Care
Outpatient
Language Services
Spanish

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Phoenix VA Healthcare System
(602) 277-5551x7640
650 East Indian School Road
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Casa de Amigas
(602) 265-9987
1648 West Colter Street
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Women, Criminal justice clients

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:
New Horizons Counseling Service Inc
(623) 939-6567
P.O. Box 56339
Phoenix, AZ
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Men, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

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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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