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Please complete this form in its entirety so we can help you receive the information you are requesting. 1. This authorization is voluntary.Edit, sign, and share michigan authorization release online. In addition to Authorization to Release Patient Information form, the Heir at Law should complete the Affidavit of Heir form below. To receive medical records, you must complete and submit the DMC Authorization to Release Medical Information. Authorization for Release of Health Information. Please complete the sections below. The medical record information release (HIPAA) form allows a patient to give authorization to a 3rd party and access their health records. Call Aetna Better Health of Michigan at 1-866-316-3784. Please sign and return this completed form to: Aetna HIPAA Member Rights Team.