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Health Records Release Authorization - The Ohio State 2026
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- Click ‘Get Form’ to open the Health Records Release Authorization in the editor.
- Begin by filling out the Patient Information section. Clearly print your full name, date of birth, and preferred phone number to ensure accurate identification.
- In the Receiving Party section, specify whether you want OSU Student Health Services to release or obtain information. Provide the recipient's name, address, and contact details.
- Select the types of information you wish to be released from the provided options. Be specific about your needs for clarity.
- Indicate the date range for which you are requesting information. Remember, future dates cannot be included.
- Choose your preferred method of release (mail, fax, email, etc.) and ensure all necessary contact details are filled in.
- Finally, review your entries for completeness and accuracy before signing and dating the form at the bottom.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2020 | 4.8 Satisfied (91 Votes) |
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