Bayhealth medical authorization 2025

1. Click ‘Get Form’ to open the bayhealth medical authorization in the editor.
2. Begin by entering your personal information. Fill in your name, address, date of birth, and telephone number in the designated fields.
3. Identify the provider or facility authorized to release your information. In this case, it is Kent General Hospital. Then specify the person or entity authorized to receive this information, such as Milford Memorial Hospital.
4. Indicate the type of records you wish to obtain by checking the appropriate boxes for inpatient, outpatient, or emergency room records along with their respective dates.
5. Select the description of information you want released. You can choose from options like Medical Record Abstract or Entire Record.
6. If applicable, check any special records that should be included, such as drug and alcohol records or mental health records.
7. State the purpose of releasing this information by selecting from options like personal use or medical treatment/management.
8. Finally, sign and date the form at the bottom. Ensure that you also provide your printed name and relationship to the patient if applicable.

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