This medical records authorization form template for word is a written permission saying you. I hereby authorize the release of my medical information to the designated recipient. A medical records release form is a document that authorizes the release of patient health information from one healthcare provider to a. Please fill out this form to authorize the release of your medical records. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription.
