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Medical Records Transfer Form

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Sample Medical Records Transfer Form Form Template
Medical Records Transfer Form Basics

This document provides a form for you to authorize the transfer of medical records from one health care provider to another.

Use the Medical Records Transfer Form document if:

  • You have a new doctor or change doctors.
  • You move to a new location.
  • You need to transfer hospital or nursing home records.
  • You need to transfer certain records to a specialist.



Other names for this document: Medical Records Release Form, Authorization to Release Medical Records


Sample Medical Records Transfer Form

More than just a template, our step-by-step interview process makes it easy to create a Medical Records Transfer Form.

Save, sign, print, and download your document when you are done.

This document is sometimes called an Authorization to Transfer Medical Records.

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