Go to download medical records authorization form template for word. To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. A medical records release authorization form is a document that allows healthcare providers to share a patient's medical records with specified parties, such as insurance companies or other. Download one of the authorization forms listed above. A medical records release form is a document that permits a medical office to disclose a patient’s protected health information.