release medical records | easy patient authorization form template

Release Medical Records | Easy Patient Authorization Form

Ensure quick and easy access to patient medical records: Download our Medical Release Form template in Docx format and fax to facilitate the care you provide.

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.docx (0.01 MB)


A medical release form, also known as a patient medical record request form, is a document used to request medical records from a healthcare provider. If you are a patient and need to obtain your medical records or want to authorize someone else to do so on your behalf, a medical release form is essential. At, we offer a professionally drafted medical release form that you can download in DOCX format, making it easy to obtain your medical records or authorize someone else to do so.

Why Do You Need a Medical Release Form?

Access to your medical records is crucial for managing your healthcare effectively. Medical professionals use your medical records to make informed decisions about your healthcare and treatment options. Obtaining a copy of your medical records can help you better understand your condition, treatment, and next steps. A medical release form allows you to:

  • Authorize the release of your medical records to a third-party, such as a family member, healthcare provider, or insurance company.
  • Obtain a copy of your medical records for personal or legal purposes.
  • Review and verify the accuracy of your medical records.

How to Use the Medical Release Form

Using the medical release form is a simple and straightforward process:

  1. Download the medical release form from in DOCX format.
  2. Fill out the form with your personal and medical information. Be sure to specify the type of records you are requesting, such as diagnostic test results, medical histories, or treatment plans.
  3. Provide the contact information of the healthcare provider(s) or institution(s) from which you are seeking records.
  4. Specify the duration of the authorization, such as a one-time request or continuous release.
  5. Sign the form and date it.
  6. If you are authorizing someone else, such as a family member or lawyer, attach a signed and dated document authorizing them to request your medical records on your behalf.
  7. Send the completed form and any attachments to the healthcare provider or institution via fax or mail, or drop it off in person.

Get Your Medical Release Form Today

Download our medical release form in DOCX format and take control of your healthcare. Don't let an inability to access your medical records hinder your medical care and decision-making. With our medical release form, you can obtain your medical records efficiently and effectively. Visit today to access a wide range of business document templates, including medical release forms and more.

The content is for informational purposes only, you should not construe any such information or other material as legal, tax, investment, financial, or other advice. Nothing contained this site constitutes a solicitation, recommendation, endorsement, or offer by Bizzlibrary or any third party service provider to buy or sell any securities or other financial instruments in this or in any other jurisdiction in which such solicitation or offer would be unlawful under the securities laws of such jurisdiction.


Ernestine Schaefer(8/13/2023) - USA

perfect file in my opinion, thank you!!

Marilu Singleton(8/13/2023) - NZL

Brilliant file from Bizzlibrary!

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