Free Medical Records Transfer Form

HIV/AIDS test results or related information should not be disclosed unless the patient or an authorized person specifically releases this information. Until recently, a general authorization for the release of medical information allowed the release of all medical records. However, it is now generally required to have a specific authorization to allow the release of HIV/AIDS information. Any authorization which specifically allows for the release of HIV information should also include a redisclosure warning, which prohibits the recipient of the medical records from redisclosing the information contained in the records without further authorization.

Medical records contain highly private and personal information and are considered confidential. Patients generally have the right to their own medical information and the right to control who else has access to their records. Therefore, with certain exceptions, medical information can only be released with the written authorization of the patient or the patient's authorized representative. This document can be used to provide the necessary authorization. Under rare circumstances, a health care provider may restrict the release of medical records to the patient if the release could be harmful to the patient or others.

Most states recognize that the actual medical records are the property of the health care provider who compiles, stores, and maintains the information. Typically, then, only copies of medical records are released and the health care provider maintains the original record. Providers can charge a fee for copying the records but should not deny the release of medical records because the patient has outstanding medical bills.

Many health care providers have very specific procedures regarding the release of medical records because of confidentiality concerns and the special protection afforded certain types of records such as HIV, mental health, and substance abuse information. Although this form specifically addresses certain types of records, providers may require you to use their specific form to authorize the release of records. Therefore, it is possible that a provider will not honor this program's form.

Some state laws specifically protect the confidentiality of mental health information. For example, the records of individuals receiving services from a mental health professional relating to the diagnosis, treatment, or care of a mental or emotional condition may be specially protected. Under rare circumstances, a health care provider may restrict the release of medical records to the patient, if the release could be harmful to the patient or others.

Under federal and some state laws, whenever certain medical information is disclosed, it must be accompanied by a statement prohibiting the recipient from redisclosing the information without a further authorization. Most health care providers will not release medical records without a redisclosure statement, even if patients are requesting the records for themselves.

1. The Authorization must be signed and dated in two places by the patient or the patient's authorized representative. The first signature block specifies what medical records can and cannot be released. The second signature block relates to the entire form.

2. A guardian or other authorized person serving in a representative capacity may sign on behalf of the patient in certain circumstances.

3. The patient should keep one copy of the authorization and provide one copy to the health care provider to be kept in the patient's medical file folder.

4. THIS PROGRAM'S AUTHORIZATION IS NOT INTENDED TO BE USED FOR THE RELEASE OF MEDICAL RECORDS FOR LITIGATION PURPOSES. A lawyer should be contacted if such a release is needed.

Laws relating to the access to health records are not uniform among all states. However, federal law regulates records generated in the treatment of substance abuse and this program specifically addresses these records. This program also treats HIV/AIDS related information and mental health treatment records separately. These records are often given extra protection to encourage diagnosis and treatment by decreasing the fear of public disclosure. This program requires a patient or representative to specifically authorize the release of these categories of information rather than relying on a general release of all records.

It is important to understand the possible consequences of restricting what information is released. If a health care provider does not have complete medical information, the provider may not be able to provide appropriate care. It is generally not recommended to withhold medical information from a treating physician or other health care provider. Additionally, many health care providers will notify the recipient of the medical records if the records are incomplete.

Federal regulations control the release of information concerning drug and alcohol treatment. The regulations were designed to encourage individuals to seek treatment for drug and alcohol abuse without fear of public disclosure. The regulations require that records of the identity, diagnosis, prognosis, or treatment of any patients kept in the performance of any federally assisted alcohol or drug abuse prevention function be kept confidential.

The general rule under the federal regulations is that no treatment information which identifies the patient may be released without the patient's written authorization. Depending on the particular state law, parental consent may or may not be required to release the information concerning a minor.

An authorization for the release of medical records should state that it is effective for a limited period of time. A maximum of one year is recommended. The authorization is also subject to revocation at any time. To revoke the authorization, written notice of a desire to revoke should be given to the health care provider who received the authorization. Such revocation would not be effective to the extent the provider has already relied upon the authorization before the revocation and released records.

In most instances, medical records can only be released with the written authorization of the patient or that of another authorized individual. Generally, parents of minor children, legal guardians, or individuals who are designated as an agent or attorney in fact under a health care power of attorney can authorize the release of the medical records. These individuals essentially authorize the release of records on behalf of the patient. Additional individuals, such as a spouse, may be able to release records in some circumstances.

While parents must usually authorize the release of records on behalf of their minor children, in some circumstances the minor child must release the record themselves. For example, if a minor is able to obtain treatment without parental consent, the minor's consent to release the records may be required. If there is any doubt about an individual's ability to request the release of records on behalf of another, it is a good idea to call the health care provider to find out whose authorization they will accept.