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TEMPLATES

Authorization to Release Information

Use this form to give consent for your healthcare provider to share your medical data with others securely and as you specify.
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An Authorization to Release Information is a document that grants permission for a healthcare provider or organization to share a patient’s personal health information with specified individuals or entities. This form outlines the specific details that can be disclosed, the purpose of the release, and the recipients of the information. By signing the Authorization to Release Information, patients ensure that their sensitive data is shared securely and in accordance with their wishes.