To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. What is a medical records release form. A medical records release form is a document that authorizes the release of patient health information from one healthcare provider to a. A medical release form is a legal document with which a patient permits their physician to share their health information with a third party. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription.
