Guest & Jail Dosing

If you are a healthcare provider looking to set up guest dosing for a non-BrightView patient, please fill out the following forms:

• Guest Dose Request Form (Sending Clinic) – to be completed by primary clinic
• Release of Information (ROI) 

Once you have submitted the forms above, a BrightView team member will contact you within three business days to verify the information provided and coordinate the next steps. 

If you are looking to set up jail dosing for a current BrightView patient who is incarcerated, please fill out the following forms: 

• Jail Dosing Request Form
• Release of Information (ROI) 

Once you have submitted the forms above, a BrightView team member will contact you within one business day to verify the information provided and coordinate the next steps. 

If you are a BrightView patient looking to guest dose at a different BrightView location or at a non-BrightView office, please speak to your care team at your next visit.

If you are not currently a BrightView patient and would like to receive guest dosing at a BrightView location, please contact your healthcare provider to help arrange your guest visit.

Your provider must submit the appropriate treatment information and a signed Release of Information (ROI) form so we can coordinate your care and ensure your medication needs are met safely and accurately.