Medical Release Form

Whether you have a private clinic or run a hospital, it is crucial to have the consent of your patients for their medical information/records to be released. Unlike printed documents, online forms can be a great way to achieve this since it is easier and more accessible. And this free medical release form template will help you create your forms in minutes!

Medical Release Form


What is a medical release form?

An online medical release form is a digital form that patients can complete to give their healthcare provider authorization to share their health information. The form can be completed and submitted electronically, which can save time and paperwork for both the patient and the provider.

This type of medical consent form can be used to authorize the release of information such as medical records, test results, and other health information. It can also be used to authorize the provider to contact other healthcare providers or specialists on the patient's behalf. The form should include the patient's name, date of birth, and contact information. The patient should also acknowledge the type of information they authorize to be released and to whom.

What is on a medical release form?

The form may include terms and conditions related to the release of information. It is important that patients review the form carefully and make sure they understand all the terms before signing it electronically. Once the form is signed, the provider will be able to access the patient's health information and release it as needed. A medical release form is an important document that should be included in every patient's medical file. A medical release form typically includes the following information:

  • Patient's name
  • Date of birth
  • Contact information
  • Questions about medical history
  • Information authorizing the release of medical records, test results, etc.
  • To whom the information will be released (e.g. healthcare provider, specialist, etc.)
  • Type of information being released
  • Signature of patient

How do I create a medical release form?

A medical release form helps to ensure that the patient's health information is available when and where it is needed. It also helps to protect the patient's privacy by authorizing only those individuals who need access to the information to have it. This form can be stored online or printed at health care provider offices.

As an all-around form builder, allows you to create agreement forms in minutes without any coding. By changing some of the content, you can also make this form suitable for a minor child by allowing his/her parents or guardians to sign. For creating better consent forms, make sure to visit our useful guides. Simply use this free medical release form template to create your own form today!

By using’s easy and extensive form builder user interface, you can create online forms, surveys, and exams with less effort than anything else! You can quickly start with a ready-made template and customize it according to your needs or you can start from scratch and build your form with many different types of form fields and customization options. 

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Let our templates do errands for you and let you focus more on critical parts of your forms and surveys such as form fields, questions, and design customization. With over 100 templates, enables you to create a form that you need and customize it according to your needs by using our form creator.

You can share your forms in any way you like. If you want to share your form and collect responses through your form’s unique link, you can simply adjust privacy settings and copy paste your form link anywhere. And if you would like to embed your form in your website, you can easily copy and paste embed code in your website HTML.

On, you can customize your form’s theme and design elements in depth. Once you switch to the ‘Design’ tab after getting your form done, you will see many different design customization options. You can change your form theme by choosing your own colors or picking one of many ready-made themes.