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What Is a Release of Information? A release of information is a document that gives a consumer the opportunity to decide what material they want released from their medical file, who they want it delivered to, how long the data can be issued, and under what statutes and guidelines it is released.The medical record information release (HIPAA) form allows a patient to give authorization to a 3rd party and access their health records. This form authorizes your physician, hospital, or other treatment provider to complete the release of medical records with us as your intermediary. Complete this form only if you want us to give information or records about you, a minor, or a legally incompetent adult, to an. Whose health records do you want? Print their full name, date of birth, patient identification number (PIN), or medical record number (MRN). Direct access to PDF of HIPAA release. Free immediate download of PDF. Request the release of your medical records with our free online Medical Records Release form.