HIPAA Medical Release Form

Anyone who wishes to authorize the disclosure of their protected health information to a third party uses a HIPAA Medical Release Form. It could be a patient, a legal guardian, or a representative appointed by the patient.

You use a HIPAA Medical Release Form when you need to permit your healthcare provider to disclose your protected health information to another party. This can be when transferring to another physician, participating in a research study, or allowing a loved one to make healthcare decisions for you.

The patient or their representative fills out a HIPAA Medical Release Form. It contains necessary details, such as the parties involved in the disclosure and the purpose of the information disclosure. Once filled and signed, it is provided to the healthcare provider, who can legally disclose the information.