I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription. To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. The sample medical release form is available online that can be used to create one in word doc format. Medical records release authorization forms are needed to legally allow sharing of an individual’s medical information. Please fill out this form to authorize the release of your medical records.
