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Click ‘Get Form’ to open the CDCR Form 7385 in the editor.
Begin with Section I, 'Patient Information.' Fill in your last name, first name, middle name, CDCR number, date of birth, and address. If you are currently incarcerated, you may leave the address blank.
Move to Section II, 'Person/Organization to Receive the Information.' Enter the name, relationship to inmate, address, phone number, and fax number of the individual or organization that will receive your health information.
In Section III, select an expiration event for your authorization. You can choose between release from custody or specify a date/event for expiration.
Proceed to Section IV. Specify the date range for hardcopy health care records you wish to be released and check any relevant boxes for types of information (e.g., medical services, mental health services).
In Section V, indicate the purpose for releasing this information by checking at least one box.
Review Section VI carefully to understand your rights regarding this authorization before signing in Section VII. Ensure all required fields are completed.
Start filling out your CDCR Form 7385 online for free today!
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