Transfer of Medical Records Consent Form

Need an online Medical Record Transfer Request template? With our ready-to-use template, you can easily create a customizable secure form. Try it out here.

About this template

As the health care provider, you can use this medical records transfer form to transfer medical records to another health care provider with the patient’s consent. All you need to do is copy this template in our form builder and personalize the form as you see fit. Afterward, share it with your patients whenever they need to authorize the transfer of their health information to another clinic or hospital. Suppose you’re handling protected health information in the United States. In that case, you can ask for our HIPAA compliance package for forms to implement the necessary safeguards on the consent and data you collect online.

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