Using Consent Forms Petal MS

When a rehab program that offers assessment and treatment for substance abuse asks a family member (including a parent), partner, employer, school, or doctor to verify information it has obtained from the client, it is making a disclosure that the client has sought help for substance abuse.

Pine Grove Recovery Center
(800) 321-8750
2255 Broadway Drive
Hattiesburg, MS
Hotline
(800) 321-8750x4812
Services Provided
Substance abuse , Detoxification
Types of Care
Hospital inpatient, Residential long-term treatment (more than 30 days), Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, Women, Men
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Clearview Recovery Center of
(601) 544-1499
3 Clearview Circle
Moselle, MS
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
Women, Men

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:
Weems Community Mental Health Center
(601) 656-3451
1011 Posey Avenue
Philadelphia, MS
Services Provided
Substance abuse
Types of Care
Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
DUI/DWI offenders, Criminal justice clients

Data Provided by:
Life Help Intensive Outpatient Program
(662) 226-1112
965 Spring Hill Road
Grenada, MS
Hotline
(662) 453-6211
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

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:
Pine Belt Mental Healthcare Resources
(601) 788-6308
91180 Highway 42 West
Richton, MS
Hotline
(888) 330-7772
Services Provided
Substance abuse
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Stevens Center of Singing River Servs
(228) 769-1280
4905 Telephone Road
Pascagoula, MS
Hotline
(228) 497-0690
Services Provided
Substance abuse , Halfway house
Types of Care
Residential long-term treatment (more than 30 days)

Data Provided by:
Weems Community Mental Health Center
(601) 782-9461
Highway 37 South
Raleigh, MS
Services Provided
Substance abuse
Types of Care
Outpatient

Data Provided by:
Region I Mental Health Center
(662) 326-4445
First Street
Marks, MS
Hotline
(662) 902-7296
Services Provided
Substance abuse
Types of Care
Outpatient
Special Programs/Groups
Persons with co-occurring mental and substance abuse disorders

Data Provided by:
Data Provided by:

Using Consent Forms

Using Consent Forms

The fact that a client has signed a valid consent form authorizing the release of information does not mean that a program must make the proposed disclosure, unless the program has also received a subpoena or court order (§§2.3(b)(1); 2.61(a)(b)). In most cases, the decision whether to make a disclosure authorized by a client’s signed consent is up to the program, unless State law requires or prohibits a particular disclosure once consent is given. The program’s only obligation under the Federal regulations is to refuse to honor a consent that is expired, deficient, or otherwise known to be revoked, false, or incorrect (§2.31(c)).

In general, it is best to follow this rule: Disclose only what is necessary, for only as long as is necessary, keeping in mind the purpose for disclosing the information.

Using consent forms to seek information from collateral sources

Making inquiries of families, partners, schools, employers, doctors, and other health care providers might, at first glance, seem to pose no risk to a client’s right to confidentiality. But it does.

When a program that offers assessment and treatment for substance abuse asks a family member (including a parent), partner, employer, school, or doctor to verify information it has obtained from the client, it is making a disclosure that the client has sought help for substance abuse. The Federal regulations generally prohibit this kind of disclosure unless the clie...

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