Release Of Information For Mental Health In Wake

State:
Multi-State
County:
Wake
Control #:
US-00458
Format:
Word; 
Rich Text
Instant download

Description

The Release of information for mental health in Wake is a legal document that allows individuals to authorize the release of their mental health treatment information to specified parties. It is particularly useful for those looking to consolidate records for legal, employment, or medical purposes. The form includes sections for the individual's personal details, the names of the entities authorized to receive information, and a comprehensive list of what information is to be released. Users must fill in their personal and relevant information clearly, ensuring the authorized representatives are correct and complete. Legal professionals, such as attorneys, paralegals, and legal assistants, can utilize this form to assist clients in managing their mental health records and ensuring compliance with privacy regulations. It is essential to highlight that the authorization remains effective until it is revoked in writing by the individual. Furthermore, a photocopy holds the same validity as the original, providing flexibility in processing. Overall, this release form is a critical tool for facilitating communication while respecting patient confidentiality.

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FAQ

WakeMed is a large, off-campus teaching site for the UNC School of Medicine — an affiliation that has been in place for over 40 years. Many physicians in the WakeMed community have graduated from medical education programs at UNC. Around 50 residents rotate at WakeMed — most from UNC with a few from Duke University.

Fax Numbers: Cary Hospital: 919-350-2285. North Hospital: 919-350-6892.

As Wake County's only provider of trauma services and a regional trauma referral center, our two trauma centers — a Level I Trauma Center at Raleigh Campus and a Level III Trauma Center at Cary Hospital — and the WakeMed Trauma teams are standing ready to provide immediate care for the seriously injured.

For immediate continuity of care requests, you or your health care provider can request that records are sent directly to their office. Use the form above, or your provider's office can fax a written request on business letterhead to 619-543-7128.

Phone Directory Department namePhone number Main Phone 469.764.8000 Business Office/Billing Questions 214.820.2278 Medical Records 469.764.9110 | Fax: 469.764.9118 Physician Referral 1.844.BSW.DOCS (1.844.279.3627) (1.844.279.3627)2 more rows

How you make your request will depend on your provider's processes. You may be able to request your record through your provider's patient portal. You may have to fill out a form — called a health or medical record release form, or request for access—send an email, or mail or fax a letter to your provider.

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Release Of Information For Mental Health In Wake