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. What is a medical record release form? 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. To get your medical history or to do it on behalf of the person who authorized you to get it through a medical release form, you have to take several steps.