Medical Records Release Authorization

About this template

Need a medical records release form for your medical practice? Jotform’s Medical Records Release Authorization template allows you to quickly and easily gather signatures from patients or parents or guardians in order to release sensitive medical records to another party. Send out invitations via email, and patients can fill out and sign your authorization form from any device. Once signed, a finalized PDF document will be automatically sent to your inbox — ready to download, print, and share for your records.

Customizing this Medical Records Release Authorization form couldn’t be easier. Using Jotform’s drag and drop builder, you can include your practice’s branding, add or change form fields and checklist items, change fonts and colors, and more. Get rid of messy paperwork and securely collect electronic signatures with Jotform Sign.

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The e-sign templates here are for informational purposes only. Jotform is not providing legal, financial, or other advice, or implying that the forms are legally valid in all or any jurisdictions. Before using any such template, consult an attorney and/or other applicable professionals to make sure that the form meets your needs, legally and otherwise.