Orthodontic release form 2025

1. Click ‘Get Form’ to open the orthodontic release form in the editor.
2. Begin by filling in your name as the Parent, Guardian, or Patient at the top of the form. This identifies who is granting permission for record release.
3. Next, specify the office that will receive the records by entering its name, address, city, state, and zip code in the designated fields.
4. In the section regarding patient information, provide the full name of the patient along with their date of birth and social security number to ensure accurate record retrieval.
5. Review any additional details about what records are being requested. Ensure you understand that these may include medical history and treatment records.
6. Finally, sign and print your name in the signature section. Indicate your relationship to the patient and enter today’s date to complete the form.

Start using our platform today for free to streamline your document editing and signing process!