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PATIENT AUTHORIZATION FOR RELEASE OF MEDICAL - Penn State Health

PATIENT AUTHORIZATION FOR RELEASE OF MEDICAL - Penn State Health 2025

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54 votes

The document is a Patient Authorization for Release of Medical Records from Penn State Health Milton S. Hershey Medical Center. It outlines the process for patients to authorize the release of their medical information, including sensitive data such as HIV/AIDS and mental health records. The form requires patient details, reasons for the request, and specifies the type of information being requested. It also includes options for how the information should be released and emphasizes that the authorization can be revoked at any time.

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Versions	Form popularity	Fillable & printable
2017	4.5 Satisfied (54 Votes)
2016	4.8 Satisfied (251 Votes)

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