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rule prohibiting disclosures are permissible if a client has signed a valid consent form that has not expired or been revoked (§2.31).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

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:
Pines and Cady Hills Chemical
(662) 327-7916
1011 Main Street
Columbus, MS
Hotline
(662) 328-0200
Services Provided
Substance abuse , Detoxification
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days)
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Golden Triangle Recovery Center Inc
(662) 324-2230
322 University Drive
Starkville, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Life Help
(662) 887-5441
200 East Baker Street
Indianola, MS
Hotline
(662) 453-6211
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Fairland Center
(662) 624-2152
3000 Highway 49 South
Dublin, MS
Hotline
(662) 902-7296
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, Men

Data Provided by:
Baptist Memorial Hospital
(662) 244-2162
525 Willowbrook Road
Columbus, MS
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Community Counseling Services
(662) 323-9318
302 North Jackson Street
Starkville, MS
Hotline
(800) 890-3127
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, Seniors/older adults, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Region IV MH/MR Commission
(662) 286-7199
401 New Hope Drive
Corinth, MS
Hotline
(888) 287-4443
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), Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Weems Community Mental Health Center
(601) 693-1001
1415 1/2 College Drive
Meridian, MS
Hotline
(601) 483-4821
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), Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Alcohol Services Center Inc
(601) 948-6220
950 North West Street
Jackson, MS
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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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