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    Chiropractic Patient Authorization to Release Medical Records


    Get this Authorization form signed in order to get access to a patient's medical records for purposes of chiropractic treatment.

    • The patient's doctor or other medical service provider is directed to release the patient's medical records to the chiropractor so that treatment can begin.
    • This is a generic patient authorization form that can be used anywhere.
    • You can easily customize the form with your logo, office address and phone number.
    • Available in MS Word format.
    Download Type: Microsoft Word
    Last Updated: 16-February-2022
    SKU: 3000