Are you a health care service provider who needs ready-to-use forms for your office? Buy and download this Request for Medical Records and Patient Authorization to Release.

The request form must be sent to another doctor who has treated a patient, requesting medical records for the patient, with an authorization form signed by the patient authorizing the previous doctor to release the records to the requesting doctor.

This Request for Medical Records form is in MS Word format, and can be edited to fit your specific needs.