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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Region III Chemical Dependency Service
(662) 844-3531x112
920 Boone Street
Tupelo, MS
Hotline
(662) 844-3531x100
Services Provided
Substance abuse , Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders
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:
Community Counseling Services
(662) 494-4066
970 Wood Street
West Point, MS
Services Provided
Substance abuse
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders

Data Provided by:
A Bridge To Recovery
(601) 977-9353
361 Towne Center Boulevard
Ridgeland, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men

Data Provided by:
Pine Belt Mental Healthcare Resources
(601) 544-4641
103 South 19th Avenue
Hattiesburg, MS
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:
North Mississippi Medical Center
(662) 377-3161
4579 South Eason Street
Tupelo, MS
Hotline
(800) 442-2238
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Communicare
(662) 252-4140
820 Highway 178 East
Holly Springs, MS
Hotline
(662) 234-7521
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:
Region I Mental Health Center
(662) 647-3240
13 North Market Street
Charleston, MS
Hotline
(662) 902-7296
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
New Beginnings Res Transitional
(601) 371-7483
2307 McFadden Road
Jackson, MS
Services Provided
Substance abuse , Detoxification, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Pregnant/postpartum women, Women, Residential beds for clients' children

Data Provided by:
Community Counseling Services
(662) 773-9377
507 West Main Street
Louisville, MS
Hotline
(662) 328-0200
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Gays and Lesbians, Seniors/older adults, Women, Men

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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