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How to use or fill out Medical Records: Release Form & FAQsUCLA Health with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Patient Information section. Ensure you print clearly and include the patient's full name, date of birth, address, and phone number.
- In the Method of Release section, select how you would like the records sent. Options include paper, PDF, or verbal communication.
- Specify the Purpose of Release by checking all applicable boxes. This helps clarify why you need the records.
- Fill in the Release To section with the name and contact details of the person or organization receiving the records.
- Indicate which specific Information to Release by selecting from provided options such as medical record abstracts or lab reports.
- Complete any additional information requested at the bottom of the form before signing and dating it.
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