Medical Records Release Form - Baptist Health South Florida 2026

1. Click ‘Get Form’ to open the Medical Records Release Form in the editor.
2. Begin by filling in your personal information, including your name, phone number, date of birth, social security number, and address. This ensures that the records are accurately associated with you.
3. Select the individual(s) or organization(s) authorized to disclose your health information. Options include various Baptist Health facilities; check all that apply.
4. Indicate who will receive the health information by selecting 'SELF' or providing details for another person/organization. Include their contact information for clarity.
5. Check the specific types of health information you wish to authorize for release. This may include test results, progress notes, and more.
6. Specify the approximate dates of treatment or events related to your request to ensure accurate record retrieval.
7. Review and sign the authorization section at the bottom of the form. Ensure you understand your rights regarding revocation and expiration of this authorization.

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