Consent: Rules about Obtaining Consent to Disclose Treatment Information Piqua OH

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Miami County Mental Health Center
(937) 335-7166
3130 North Dixie Highway
Troy, OH
Hotline
(800) 537-3422
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women
Language Services
ASL or other assistance for hearing impaired

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Shelby County Counseling Center Inc
(937) 492-6970x201
500 East Court Street
Sidney, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

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Comprehensive Addiction Service System
(419) 867-9966
1150 South McCord Road
Holland, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

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Community Based Outpatient Clinics
(330) 489-4600x1633
733 Market Avenue South
Canton, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, Men, Criminal justice clients

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Rosary Hall
(216) 363-2580
2351 East 22nd Street
Cleveland, OH
Hotline
(216) 436-2000
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders
Language Services
ASL or other assistance for hearing impaired

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Miami County Recovery Council
(937) 335-4543
1059 North Market Street
Troy, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Women

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TCN Behavioral Health Services Inc
(937) 376-8700
600 Dayton-Yellow Springs Road
Fairborn, OH
Hotline
(937) 376-8700x6
Services Provided
Substance abuse
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Outpatient
Special Programs/Groups
Men
Language Services
ASL or other assistance for hearing impaired

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Nova House Association Inc
(937) 253-1680x211
732 Beckman Street
Dayton, OH
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Pregnant/postpartum women, Women, DUI/DWI offenders, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired

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New Visions Unlimited Inc
(216) 663-0200
15105 Broadway Avenue
Maple Heights, OH
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Criminal justice clients

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Alcoholism Council of Cincinnati Area
(513) 281-7880
2828 Vernon Place
Cincinnati, OH
Hotline
(513) 281-7422
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Gays and Lesbians, Women
Language Services
ASL or other assistance for hearing impaired, Spanish

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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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