Medical Release Form Template

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This secure medical release form makes it easy for healthcare providers to stay compliant and paper-free. Get it now & put it to work in minutes.

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About this template

This medical release form template enables healthcare providers to receive authorization from patients or their legal guardians to share the patient’s information with other parties before providing any treatment. Customize it as you see fit using our HIPAA-secure form builder. No coding, no hassle, no endless paperwork.

Ditch the paperwork by using our online medical release form to speed up obtaining consent from your patients or their parents and increase your efficiency. Use the time gained to offer your patients a stellar experience in your facility.

Build it from scratch or update our existing template and share it with your patients prior to their visit, so they can have a smooth experience.

Frequently Asked Questions

What are medical release forms?

Medical release forms are documents that give healthcare providers permission to share the patient’s medical information with other parties that can help diagnose and treat the patient’s condition.

What is on a medical release form?

The medical release form contains an agreement that explains what the patient or the patient’s legal guardian needs to consent to before starting the treatment. If the patient is a minor, the legal guardian or parent has to provide both personal details such as name, email, and phone, as well as the relationship with the child, and the name of the family’s physician. Allergies and medications must be filled in the document too since they can affect the way the patient reacts to certain treatments.  

How do you create a medical release form?

You can customize our medical release form template on 123FormBuilder without worrying about building one from scratch. You can update the consent agreement, change the fields, add your logo, an electronic signature, and more. And you don’t need programming skills, just a 123FormBuilder account.

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Is this Medical Release Form template HIPAA-compliant?

Yes, 123FormBuilder is HIPAA-compliant but only if you contact us for an Enterprise plan that includes HIPAA-compliant forms. Once we understand your needs, we’ll tailor our form builder according to your needs.

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