These records are given additional protection due to the stigma associated with these conditions. These laws also treat HIV/AIDS related information and medical health treatment records separately. Federal law dictates the release of records that are generated in relation to the treatment of substance abuse/addiction. The Patient will send this signed document and keep a copy for themselves to keep in their personal records.īoth federal and state laws control the keeping and release of medical records. a signature authorizing the release of specific records related to especially sensitive areas and 2. The Authorization must be signed in two places: 1. Once this document is completed, the Patient should sign both the letter and the Authorization of Medical Records Release form. However, the form included with this document is a general purpose authorization that will work in many circumstances. The Healthcare Provider may have a specific form the Patient is required to submit to authorize the release of records. Many Healthcare Providers have very specific procedures regarding the release of medical records due to confidentiality concerns. HIV status, mental health treatment, substance abuse/addiction). This section includes necessary information including information identifying the Patient, the name and contact information of the Recipient of the medical records, and specific authorization to release medical information related to especially sensitive conditions (e.g. This form gives the Healthcare Provider permission to release medical records to a specified Recipient. The second section is an Authorization of Medical Records Release form. This section includes important information such as the Patient's contact information, the reason for this request, and any alternate names under which the medical records may be filed. The first section is a letter from the Patient to the Healthcare Provider requesting that they release the medical records. This document is made up of two sections. This document is used both to request and authorize the Healthcare Provider to release this information. Therefore, with a few exceptions, medical information can only be released with written authorization from the Patient (or their authorized representative). Patients generally have the right to their own medical records and the right to dictate who else shall have access to their records. Medical records contain sensitive and personal information and are considered protected and confidential. This Medical Records Request document is used by a Patient to request that a Healthcare Provider who has treated them release their medical records to a specific Recipient.
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