Ynhh 2025

1. Click ‘Get Form’ to open the ynhh document in the editor.
2. Begin by entering your legal name in the designated fields for last name, first name, and middle initial. Include your preferred name if applicable.
3. Fill in your date of birth, phone number, email address, and complete address including street or box number, city, state, and zip code.
4. Select the purpose for which you are requesting access to your medical information by checking the appropriate boxes.
5. Authorize the release or obtain information by filling in the recipient's details such as name, phone number, and address.
6. Indicate how you would like to receive your medical records by selecting from options like MyChart, mail, fax, or secure email.
7. Review all sections carefully before signing at the bottom of the form. Ensure that you check any specific information you do not want released.

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