Address. Telephone Number. City. State. Direct free access to PDF of HIPAA release.Free immediate download of medical relasese form PDF. How do I fill this out? All of the Federal Employees Program's online forms (with the exception of Forms CA-16 and CA-27) are available to print and to manually fill and submit. Find provider prior authorization resources for Humanaʼs Medicaid program specific to Humana Healthy Horizons in Ohio (Medicaid) coverage. The medical record information release (HIPAA) form allows patients to give authorization to a 3rd party and access their health records.