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2. Medical Records Release Authorization Forms - OpenDocs

   opendocs.com/health/hipaa-release

   A medical records release authorization form is a document that allows a person to disclose protected health information to a third party. A patient can also request their medical records not currently in their possession.

3. AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS - PatientPop

   sa1s3.patientpop.com/assets/docs/223399.pdf

   TO REQUEST RELEASE OF MEDICAL INFORMATION PLEASE COMPLETE AND SIGN THIS FORM. I, ____________________________________hereby voluntarily authorize the disclosure of information from my health record. (Name of Patient)

4. Medical Records Release Authorization Form (Waiver) | HIPAA

   eforms.com/release/medical-hipaa

   The medical record information release (HIPAA) form allows patients to give authorization to a 3rd party and access their health records. It also allows the added option for healthcare providers to share information. Powers granted under a medical release can be revoked or reassigned at any time.

5. Medical Records Release (HIPAA) Form - Legal Templates

   legaltemplates.net/form/medical-records-release-form

   Download a medical records release (HIPAA) form to authorize healthcare providers to release medical information.

6. Authorization for Release of Health Information - Beaumont Health

   www.beaumont.org/docs/default-source/medical...

   Release a copy of my health information to me. Release my health information to someone else. I have listed where I would like my health information to be sent in Section 6. Obtain copies of my health information. I have listed the names of the health care providers that I would like you to request my information from in Section 6.

7. AUTHORIZATION TO USE OR DISCLOSE PROTECTED HEALTH INFORMATION ...

   www.trinityhealthmichigan.org/sites/default/...

   Sensitive Information: I request the following Information be released, which may include: alcohol and drug abuse/treatment; psychological and social work counseling; HIV, AIDS or ARC; communicable disease or infections, including sexually transmitted disease, venereal disease, tuberculosis and hepatitis; genetic information and demographic inf...