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01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out the record release form with our platform
- Click ‘Get Form’ to open the record release form in the editor.
- In Section I, print the name of the applicant or member who is requesting the medical information.
- Proceed to Section II and enter the name, address, and telephone number of the health-care provider authorized to share medical information.
- In Section III, specify what medical information can be shared. Check any boxes if you wish to restrict sharing of sensitive information like AIDS/HIV status or drug/alcohol use.
- Sign and date the form in Section V. Ensure that all signatures are original and written in ink. If applicable, a parent or legal guardian must sign for minors.
- Review all sections for completeness before submitting. Remember, leaving any section blank may invalidate your request.
Start using our platform today to easily fill out your record release form online for free!
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