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Medical Records Transfer Form

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  • Build your
    document
  • Save, print
    & share
  • Sign it &
    Make it legal
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

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