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Alcoholism and Chemical Dependency Programs Authorization for Release of Information - North Carolina
Alcoholism and Chemical Dependency Programs Authorization for Release of Information is a legal document that was released by the North Carolina Department of Public Safety - a government authority operating within North Carolina.
FAQ
Q: What is the Alcoholism and Chemical Dependency Programs Authorization for Release of Information?
A: The Alcoholism and Chemical Dependency Programs Authorization for Release of Information is a form used in North Carolina to obtain consent for the release of confidential information related to alcoholism and chemical dependency treatment.
Q: What is the purpose of this form?
A: The purpose of this form is to allow individuals to give consent for the release of their confidential information related to alcoholism and chemical dependency treatment.
Q: Who needs to complete this form?
A: Individuals who have sought or received treatment for alcoholism or chemical dependency in North Carolina may be required to complete this form.
Q: What information can be released with this authorization?
A: With this authorization, information related to alcoholism and chemical dependency treatment can be released, such as medical records, treatment plans, and progress notes.
Q: Is this form mandatory?
A: No, this form is not mandatory, but it may be required by certain treatment providers or organizations in North Carolina.
Form Details:
- Released on March 5, 2019;
- The latest edition currently provided by the North Carolina Department of Public Safety;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the North Carolina Department of Public Safety.
