Consent: Rules about Obtaining Consent to Disclose Treatment Information Sunnyvale CA

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Community Health Awareness Council
(650) 965-2020x13
711 Church Street
Mountain View, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Gays and Lesbians, Criminal justice clients
Language Services
Arabic, Chinese, French, German, Spanish

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Kaiser Permanente Medical Group
(408) 366-4200
19000 East Homestead Road
Cupertino, CA
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Men
Language Services
Spanish

Data Provided by:
Catholic Charities of Santa Clara Cnty
(408) 468-0100
2625 Zanker Road
San Jose, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Men

Data Provided by:
Horizon Services
(408) 283-8555
650 South Bascom Avenue
San Jose, CA
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less)
Special Programs/Groups
Men

Data Provided by:
North County
(650) 328-1441
231 Grant Avenue
Palo Alto, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
Spanish, Vietnamese

Data Provided by:
Pathway Society Inc
(408) 244-1834
1825 De La Cruz Boulevard
Santa Clara, CA
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Recovery Connections Trt Servs LLC
(408) 249-9927
807 Park Court
Santa Clara, CA
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

Data Provided by:
Asian Americans for
(408) 975-2730
2400 Moorpark Avenue
San Jose, CA
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Residential beds for clients' children, DUI/DWI offenders, Criminal justice clients
Language Services
Chinese, Spanish, Vietnamese

Data Provided by:
Santa Clara Cnty Dept of Alc/Drug Serv
(408) 885-5400
2425 Enborg Lane
San Jose, CA
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Pregnant/postpartum women
Language Services
Spanish

Data Provided by:
Adolescent Counseling Services
(650) 329-9410
445 Sherman Avenue
Palo Alto, CA
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Criminal justice clients

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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