FREE 9+ Medical Record Release Form Samples in MS Word | PDF

Authorizing of release of medical records is a type of authorization form that allows for the legal disclosure of sensitive medical information about an individual’s current state of health and is provided by law to be kept secure unless authorized by the patient himself to allow another individual to examine his or her records.

In this case, it would require a medical record release form, which is a type of Sample Form that allows for the legal disclosure of confidential medical records, which in any other case would be deemed an illegal and unprofessional act on the medical practitioner’s part and is punishable as a serious offense that may result in the medical practitioner’s unemployment or jail time, or, in some cases, both.

Authorization for Release of Medical Record Information

Medical Records Release Form in PDF

General Medical Records Release Authorization Form in PDF

Authorization for Release of Health Information Sample

Patient Medical Authorization Release Form in PDF

Generic Medical Record Release Forms

Authorization for Release of Medical Record Information

Is the act of authorizing or requesting the release of medical information by either the patient or his or her representative. This is to ensure privacy and security in terms of sharing an individual’s medical information with other authorized individuals.

Medical Records Release Form

Is a form necessary to the releasing of confidential medical information about a certain individual’s state of health and medical history. This is needed to avoid inappropriate releasing of confidential medical records.

This could be used in response to as a proof of sickness or an effective reason to being unable to repay a debt of which a Lien Release Form was used in agreeing to the payment of a debt.

Patient Medical Authorization Release Form

This form is to allow the patient to authorize his or her representative to claim the release of confidential medical information relating to the patient.

HIPAA Medical Record Release Form

Health Insurance Portability and Accountability or HIPAA is a legally binding agreement to secure and ensure the privacy of medical information. This form is to allow the release of medical information by HIPAA.

Dental Records Release Form

This form allows for the release of a patient’s dental records either to the patient himself or herself or by a representative of the patient.

HIPAA Medical Record Release Form Sample

Medical Record Release Form in Word

Blank Medical Record Release Form Sample

Dental Records Release Form Sample

Simple Medical Records Release Form

Importance of Releasing Medical Records

• Legal Issues
  • In which a proof of health or a proof of sickness is required so as to settle a legal case that involves the individual’s medical status as an essential piece of evidence to a case.
  • Such types of cases would involve whether or not the patient was under any influence such as narcotics, alcohol, or similar forms of mood-altering substances that would have affected the individual’s ability to function normally.
• Claiming of Medical Benefits
  • In most cases, it is required for submission of medical records or proof of illness or injury to avail for any medical or health benefits that the individual has in terms of personal health insurance, medical or health benefits from the company or organization the individual is employed to.

 

Similarly to a releasing of a medical record, some companies or organizations will require you to sign a Liability Release Form so as to be authorized to accomplish a certain task or objective on the company or organization’s behalf.