Consent: Rules about Obtaining Consent to Disclose Treatment Information Wallingford CT

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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

Connecticut Valley Hospital
(860) 262-5000
Silver Street
Middletown, CT
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient
Special Programs/Groups
Pregnant/postpartum women, Women
Language Services
ASL or other assistance for hearing impaired, Creole, French, Polish, Portugese, Russian, Spanish

Data Provided by:
Wakeman Hall at the Childrens Ctr of
(203) 248-2116x341
1400 Whitney Avenue
Hamden, CT
Services Provided
Substance abuse
Types of Care
Residential short-term treatment (30 days or less), Outpatient
Special Programs/Groups
Adolescents, Residential beds for clients' children, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Connection House
(860) 343-5512
167 Liberty Street
Middletown, CT
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with HIV/AIDS, Women, Men, Criminal justice clients

Data Provided by:
Northside Community Outpatient Servs
(203) 503-3470
226 Dixwell Avenue
New Haven, CT
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Chemical Abuse Services Agency Inc
(203) 495-7710
426 East Street
New Haven, CT
Services Provided
Substance abuse , Methadone Maintenance, Methadone Detoxification, Buprenorphine Services
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Pregnant/postpartum women, Women, Men, Criminal justice clients
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Rushford Center Inc
(860) 346-0300
1250 Silver Street
Middletown, CT
Hotline
(800) 567-0902
Services Provided
Substance abuse , Detoxification
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Connection Inc
(860) 343-5510
196 Court Street
Middletown, CT
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Women, Men

Data Provided by:
Connecticut Counseling Centers Inc
(203) 755-8874
4 Midland Road
Waterbury, CT
Services Provided
Substance abuse , Detoxification, Methadone Maintenance, Methadone Detoxification
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Persons with HIV/AIDS, Pregnant/postpartum women
Language Services
ASL or other assistance for hearing impaired, Spanish

Data Provided by:
Affiliates for
(203) 562-4235
389 Orange Street
New Haven, CT
Services Provided
Substance abuse , Detoxification, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents

Data Provided by:
Crossroads Inc
(203) 821-3040x21
42 Howe Street
New Haven, CT
Services Provided
Substance abuse , Buprenorphine Services
Types of Care
Hospital inpatient
Special Programs/Groups
Women, Residential beds for clients' children
Language Services
Spanish

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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