Under the Your Menu tab, click Request Medical Record. Fill out the fields on the form page, sign electronically, and submit.Release of my records will be for the purpose stated on this form. We hope you'll contact the Area Agency on Aging (AAA) SeniorLine and ask for more information about our Caregiver Support Programs. Authorization for Release of Medical Records and Confidential Information. I authorize the Allegheny County Health Department to release the medical records. We will only accept applications in the newest version. ALL applications MUST BE MAILED to the address listed below. Allegany County Department of Social Services 7 Court Street County Office Bldg.