Go to download medical records authorization form template for word. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription. 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. The sample medical release form is available online that can be used to create one in word doc format. Fax or mail the appropriate site listed on page 2 of the.
