This post reviews what is required for a medical release authorization. I hereby authorize the following health care professional, medical facility, mental health facility, laboratory, paramedical facility, medical examiner, medical records service, prescription. A medical records release form is a document that authorizes the release of patient health information from one healthcare provider to a. 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. A medical records release form is a document that permits a medical office to disclose a patient’s protected health information.