Alabama Medical Release Form

State:
Alabama
Control #:
AL-010-01-CP
Format:
Word; 
Rich Text
Instant download

Description

This Medical Release authorizes the physicians, hospital and all medical attendants to furnish full and complete medical reports and information requested by the person signing to whomever such person designates in the agreement. This authorization also includes examination of all hospital records, x-ray film and furnishing of any information including opinions.

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FAQ

Medical release forms are used to request that a healthcare provider share a patient's medical history with a third party (employer, insurance company, school, etc.).

By signing an authorization to release information, a party is consenting to provide another party with access to otherwise confidential information or records about an individual. However, signing a release doesn't mean the complete loss of confidentiality because most authorization forms are subject to limitations.

A Medical Records Release Form (also known as a Medical Information Release Form) is a form used to request that a health care provider (physician, dentist, hospital, chiropractor, psychiatrist, etc.)The automated form allows you to request information to be sent to multiple individuals and organizations at once.

A medical release form is a document that gives healthcare professionals permission to share patient medical information with other parties.

Dear Recipient's name, I am writing you to request copies of my medical records. I was treated in your office on xx/xx/xxxx. Please include all of my charts, test results, and consultation notes including referrals regarding my medical care.

Patient requests must be written without requiring a "formal" release form. Include signature, printed name, date, and records desired. Release a copy only, not the original. The physician may prepare a summary of the medical record, if acceptable to the patient.

Patient requests must be written without requiring a "formal" release form. Include signature, printed name, date, and records desired. Release a copy only, not the original. The physician may prepare a summary of the medical record, if acceptable to the patient.

Whether requesting your personal medical records from a doctor's office or a hospital, in Hawaii or Ohio, the federal law known as HIPAA applies. HIPAA entitles every person the right to access his or her medical records, receive copies of them, and request amendments to them.

Under HIPAA, they are required to provide you with a copy of your health information within 30 days of your request. A provider cannot deny you a copy of your records because you have not paid for the health services you have received.

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Alabama Medical Release Form