Request Medical Records Release Form Template. Choose Medical Record Request and follow the prompts. Recipient Identities of the other persons who may have a right to access the information.
Patients generally have the right to their own medical records and the right to dictate who else shall have access to. Once the permission is transferred to other previous permission holder cannot access the medical records anymore. Most of the forms also specify the type of medical data that are to be released.
Medical records contain sensitive and personal information and are considered protected and confidential.
Medical records contain sensitive and personal information and are considered protected and confidential. The patient authorizes the releaser to release his medical information to the receiver because the patient is changing doctors. This Medical Records Request document is used by a Patient to request that a Healthcare Provider who has treated them release their medical records to a specific Recipient. And the signature should be placed at the end of the file.