Using Consent Forms Two Rivers WI

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.

MARCO Services Inc
(920) 684-0605
1114 South 11th Street
Manitowoc, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential long-term treatment (more than 30 days)
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Calumet County Dept of Human Services
(920) 849-1400
206 Court Street
Chilton, WI
Hotline
(920) 832-4646
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Behavioral Medicine Center
(262) 928-4068
2085 North Calhoun Road
Brookfield, WI
Hotline
(262) 928-4036
Services Provided
Substance abuse treatment, Detoxification, Buprenorphine Services
Types of Care
Hospital inpatient, Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Seniors/older adults, Women, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Affiliated Counseling Center LLC
(920) 922-7440
17 Forest Avenue
Fond du Lac, WI
Hotline
(920) 576-8866
Services Provided
Substance abuse treatment, Buprenorphine Services
Types of Care
Outpatient
Special Programs/Groups
Adolescents, Persons with co-occurring mental and substance abuse disorders, DUI/DWI offenders

Data Provided by:
Hope Haven Inc
(608) 251-8881
425 West Johnson Street
Madison, WI
Services Provided
Substance abuse treatment
Types of Care
Residential long-term treatment (more than 30 days)
Special Programs/Groups
Seniors/older adults, DUI/DWI offenders, Criminal justice clients

Data Provided by:
Kewaunee County Dept of Human Services
(920) 388-7030x270
810 Lincoln Street
Kewaunee, WI
Hotline
(920) 388-7030
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
Menominee Cnty Hlth Human Servs Dept
(715) 799-3861
W3272 Wolf River Road
Keshena, WI
Hotline
(715) 799-3861
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Language Services
ASL or other assistance for hearing impaired

Data Provided by:
Jackie Nitschke Center Inc
(920) 435-2093
700 Cherry Street
Green Bay, WI
Services Provided
Substance abuse treatment
Types of Care
Outpatient
Special Programs/Groups
DUI/DWI offenders

Data Provided by:
ARC Community Services Inc
(608) 283-6426
1409 Emil Street
Madison, WI
Services Provided
Substance abuse treatment
Types of Care
Residential long-term treatment (more than 30 days), Partial hospitalization/day treatment
Special Programs/Groups
Women, Criminal justice clients
Language Services
Spanish

Data Provided by:
Arbor Place Inc
(715) 235-4537x106
320 21st Street NE
Menomonie, WI
Services Provided
Substance abuse treatment, Halfway house
Types of Care
Residential short-term treatment (30 days or less), Residential long-term treatment (more than 30 days), Outpatient, Partial hospitalization/day treatment
Special Programs/Groups
Adolescents, Women, Men, DUI/DWI offenders
Language Services
ASL or other assistance for hearing impaired

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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