Fax or mail the appropriate site listed on page 2 of the. Medical release forms include details about. A medical release form is a legal document with which a patient permits their physician to share their health information with a third party. To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription.
