The releasor authorizes his/her employer to release employment references including, but limited to, his/her employment history and wages and any information which may be requested relative to his/her employment, employment applications, and other related matters, and to furnish copies of any and all records which the employer may have regarding his/her employment.
Release Of Information Form Mental Health In North Carolina
Category:
State:
Multi-State
Control #:
US-00458
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
For information about your medical record, please see this Medical Records page or call (984) 974-3226. If you would like to request a copy of information in a medical record, please FAX a completed authorization form to (984) 974-0474.
For information about your medical record, please see this Medical Records page or call (984) 974-3226. If you would like to request a copy of information in a medical record, please FAX a completed authorization form to (984) 974-0474.
Check their website: Information about how to get your health record may be found under the Contact Us section of a provider's website. It may direct you to an online portal, a phone number, an email address, or a form. Phone or visit: You can also call or visit your provider and ask them how to get your health record.
A. Adults: 11 years after last date of patient encounter if no litigation, claim, audit, or official action involving the records has been initiated.
Who has the right to keep my original medical record? Under North Carolina law, your health care provider is required to keep your original medical record. You have the right to see and get a copy of it.
Anyone with knowledge that a person is dangerous to himself or others due to mental illness and/or substance abuse may present to the local magistrate's office to file a petition for involuntary commitment.
