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Release of Information

    Release of Information

    Your teen's information belongs to them — and protecting it is something we take seriously. As a parent or caregiver of a minor, you have the ability to authorize the sharing of your teen's treatment records when that collaboration will genuinely serve their care — whether that's with a school, an outside provider, or another organization working to support them.

    The Release of Information form below lets you specify exactly who the information goes to, what can be shared, and in which direction. Nothing leaves without your explicit authorization.

    This process is governed by HIPAA — but our commitment to privacy goes beyond legal compliance. Protecting your teen's information is a direct reflection of two of Bright Path's core values: integrity and dignity. We handle what's been entrusted to us with care, and we don't cut corners on the things that matter most.


    Before You Begin

    Before filling out the form, please have the following information ready:

    • Name of the recipient or sender — This may be a therapist, doctor, hospital, treatment facility, school counselor, or family member. If identifying an organization, include the name of the primary contact person.
    • Their contact information — You will need an email address, physical mailing address, and phone number. A fax number is optional.
    • Type of authorization — Choose one of the following:
      • Exchange — Both parties may send and receive information
      • Release — Bright Path may send information to the other party, but not receive
      • Receive — The other party may send information to Bright Path, but Bright Path may not send any in return

    Scope of disclosure — You may authorize release of the entire medical record or select only specific types of information. Even when "Entire Medical Record" is selected, Bright Path will only disclose the minimum information necessary for collaboration of care, per HIPAA guidelines.



    Location Information


    Bright Path Behavioral Health — Wake Forest 203 Capcom Ave #104 Wake Forest, NC 27587

    Bright Path Behavioral Health — Hillsborough 980 Corporate Dr Hillsborough, NC 27278


    Questions or Assistance


    If you have questions about the release of information process or need help completing the form, please contact our team directly.

    Phone: 919-578-5517 Email: info@brightpathbh.com