Attorneys: HCMC employees looked at George Floyd's private 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's information, including their full legal name, date of birth, maiden name or alias, social security number, and phone number.
3. In the 'Health Information Released FROM' section, select either Hennepin Healthcare System or specify another organization by providing its name and address.
4. Fill out the 'Health Information Released TO' section with the recipient's details, ensuring you include a complete address and fax number if applicable.
5. Indicate the health information to be released by specifying dates of service and types of visits. Be sure to initial any sensitive information you do not wish to release.
6. Choose the form or format for release—hard copies, electronic formats, verbal exchange, or review of records—and indicate your preferred delivery method.
7. Complete the authorization section by signing and dating the form. Ensure that any legal representatives provide necessary documentation.

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