Medical Records Release - Southern Oregon Pediatrics 2026

1. Click ‘Get Form’ to open the Medical Records Release in the editor.
2. In the first section, select whether you authorize Southern Oregon Pediatrics or another practitioner/facility to disclose your medical records by checking the appropriate box.
3. Fill in the patient's name and date of birth in the designated fields to ensure accurate identification.
4. Indicate how you would like the records sent by checking either 'electronically' or 'by paper via fax/mail'.
5. Specify where to send the records by selecting Southern Oregon Pediatrics or entering another practitioner's name and their address details.
6. Initial next to any sensitive information you consent to be sent, such as psychological information or substance abuse records.
7. Review the authorization statement carefully, then provide your name, relationship to the patient, signature, and date at the bottom of the form.

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