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Medical Records Release Authorization Form Template

To request release of medical information please complete and sign this form i, ____________________________________hereby voluntarily authorize the disclosure of. Completed and signed forms can be submitted the following ways: I hereby authorize the release of my medical information to the designated recipient. 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. 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.

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