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HIPAA Authorization Form
Need to share your medical records with a new doctor, an insurance company, or a family member? A HIPAA Authorization Form gives the green light for a covered entity to release your protected health information — but only to the specific people you choose. This template lets you specify exactly which records to share, the purpose of the disclosure, and a clear expiration date. Revoke it whenever you want. Fill out the details, preview instantly, and download as PDF or Word — completely free, no sign-up required.
Medical Records Release Authorization
Switching doctors, applying for disability benefits, or dealing with an insurance dispute? You'll likely need to authorize the release of your medical records. This form lets you specify exactly which records, from which provider, to whom, and for what purpose — keeping you in control of your own health data. It's required under HIPAA and state privacy laws. Our template covers the patient and provider info, record types, authorized recipients, and expiration. Fill it out, preview, and download as PDF or Word — free, no account.