REQUEST FOR RELEASE OF PATIENT INFORMATION - breastscreen qld gov 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Patient Details' section. Enter your surname, given name(s), sex, date of birth (DOB), record location, date of request, and time. Ensure all information is accurate for a smooth processing.
3. In the 'RBWH Record Details' section, provide your RBWH Unit Record Number and specify whether you need the information within 2 working days by ticking 'Yes' or 'No'.
4. Complete the 'Person Requesting Information' section with your title, surname, given name, hospital/surgery affiliation, address, suburb, postcode, and phone number. This identifies who is requesting the information.
5. Indicate what specific information you require by ticking the relevant boxes under 'Information Required'. Include any special instructions if necessary.
6. The patient or guardian must sign in the 'CONSENT TO RELEASE OF INFORMATION' section to authorize the release of their medical records.

Start using our platform today to easily fill out and submit your REQUEST FOR RELEASE OF PATIENT INFORMATION form for free!