Here's how it works
01. Edit your emory release form 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 emory hospital patient information via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out emory health information with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your Medical Record Number at the top of the form for internal tracking.
- Fill in your personal details, including your name, last four digits of your SSN, address, date of birth, and contact numbers. Ensure accuracy for seamless processing.
- Select the Emory Healthcare facility from which you wish to receive records by checking one or more options provided.
- Indicate how you would like to receive your health information by selecting a delivery method and format. Fill in any additional required details such as email or mailing address.
- Specify the health information you want disclosed by checking the appropriate boxes and providing dates of service if necessary.
- Review the important notice regarding email requests and ensure you understand the expiration terms before signing.
- Sign and date the form at the bottom to authorize the release of your health information.
Start using our platform today for free to manage your Emory health information effortlessly!
Fill out emory health information online
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