This medical records authorization form template for word is a written permission saying you. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription. The sample medical release form is available online that can be used to create one in word doc format. To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. A medical release form is a legal document with which a patient permits their physician to share their health information with a third party.
