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Medical Records Release Authorization Form Template

To get your medical history or to do it on behalf of the person who authorized you to get it through a medical release form, you have to take several steps. Jotform’s medical records release authorization template allows you to quickly and easily gather signatures from patients or parents or guardians in order to release sensitive medical records. Fax or mail the appropriate site listed on page 2 of the. To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. A medical records release form is a document used to authorize the transfer of a patient's medical records from one healthcare provider to another.

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