Release record edit 2026

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4.8 out of 5

67 votes

The document is an authorization form for patients to request the release of their medical records from Michigan Medicine. It outlines the necessary information required from the patient, including personal details, delivery methods, and purposes for the record request. The form emphasizes that signing is voluntary and does not affect treatment or benefits. It also includes information on fees associated with record requests, processing times, and instructions for submitting requests.

Here's how it works

01. Edit your release record online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send release record form via email, link, or fax. You can also download it, export it or print it out.

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Click ‘Get Form’ to open the release record edit in the editor.
Begin by filling in your personal information, including your name, maiden name (if applicable), date of birth, and contact details. Ensure accuracy for a smooth processing experience.
Select your preferred delivery method for receiving the medical records. Options include electronic delivery via email or US Mail.
Indicate the purpose of the release by selecting from the provided options, such as 'Continuation of Care' or 'Attorney/Legal'. This helps clarify why you need the records.
Specify which records you wish to be released. You can choose from predefined packages or detail specific documents needed.
Review all entered information for accuracy before signing and dating the authorization at the bottom of the form.

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See more release record edit versions

We've got more versions of the release record edit form. Select the right release record edit version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (67 Votes)
2020	4.3 Satisfied (137 Votes)
2019	4.3 Satisfied (53 Votes)
2018	4.1 Satisfied (68 Votes)
2015	4.3 Satisfied (264 Votes)
2012	4.4 Satisfied (60 Votes)

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Release record edit 2026

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