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. 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. Download one of the authorization forms listed above.