Printable Medical Records Release Form (Word, PDF)

patient medical records release form

People use medical records release form to get copies of a person’s health records from the health department. Medical records play an important role in a person’s health or medical care. This document helps the patients and doctors to keep track of the patient’s official medical details throughout their life. Moreover, these records can be as simple as handwritten notes.

People requested medical records for different reasons such as;

  • When patient is moving to a different town, city, state, or locality.
  • Due to unavoidable circumstances, when patients have to change their primary physicians.
  • For legal action, when patient wants to appeal third parties for medical consequences.
  • When employee wants to proof rightful absence to his employer.

The medical records are used for different purposes on the basis of the need at hand.

Reasons for having your medical records:

You should have your medical records because it allows you to update information relevant to your health care. It makes you able to determine inconsistencies like missing or incorrect information in order to make appropriate corrections. In the records, for clarification, it provides patients a chance to ask about prescriptions or test results.

Furthermore, the patients or their representatives have the authority to request their medical records. It doesn’t matter either the records are on paper or electronically stored. EMR are the medical documentation that stored in digital or electronic health care systems.

Who can request medical records?

In the HIPPA medical records release form, the following people can request for medical records;

Personal representatives:

Under HIPPA, personal representatives are the individuals who are legally allowed to make and implement medical decisions on behalf of another person. This form other than the patient permits the patient’s parent, partner, family, friends, or primary care physician to access patient’s medical records.

Adult or legal guardian:

The minor’s legal or adult guardians that are 18 years of age allowed to access the minor’s medical records. By using documents, consent is given that transfer legal custody to the adult. In addition, caregivers and advocates can access their client’s medical records.

The administrator of the estate:

A HIPPA form allows the estate administrators to access one’s medical records. But, they also have to present a signed medical authorization release form. If the patient is deceased then with the help of a Last Will and Testament or court, the administrator can obtain the records.

Records that can be requested:

Physicians are not allowed to provide every patient medical record in their possession. The patient only has the authority to his or her medical information in legal terms. The following patient’s medical records can be requested;

Records of adults

For adult patients, most physicians have to keep medical records for the previous six years. Adults can ask for this information when need arises.

Records of children

After the age of 18 or 21, healthcare providers are required to keep children’s medical records for at least three to ten years.

Lab reports

In a patient’s medical records, Lab tests and Admission Records are included and might be requested.

Records from retired doctors:

If the doctor has been retired then he has to transfer the patient’s records to another health care provider.

Records that can be denied:

In order to protect doctors and patients, there are some medical records that your healthcare provider is legally permitted to deny you access to. These records can be denied;

  • Mental health records
  • Consent form to obtain records
  • Psychotherapy notes
  • Lawsuit records
  • ER records
  • Harmful records
  • On-going research records


In conclusion, a medical record release form is a useful tool that assists you in getting copies of a person’s health records. There are different ways to get your medical records on the basis of law or the circumstances.

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