Fax or mail the appropriate site listed on page 2 of the. 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. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription. 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. Medical release forms include details about.