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A Medical Release Form is used by health care facilities, sports organizations, and other applicable organizations to protect themselves from legal liabilities that might arise from a certain task or procedure. A Medical Release Form works a lot like a Consent Form, wherein the person who signs the form gives consent to the company or organization to perform a certain task, such as releasing a patient’s health information or facilitating a minor’s medical treatment, among other things.

There are mainly two types of Medical Release Forms provided on this article. Those are Medical Records Release Forms and Child Medical Release Forms. Read on to find more information.

Child Medical Release Forms

Child Overnight Medical Release

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Size: 57 KB

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Child Comprehensive Medical Release

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  • PDF

Size: 183 KB

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Child Ministry Medical Release

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  • PDF

Size: 104 KB

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Child Medical Release

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  • PDF

Size: 320 KB

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Medical Records Release Forms

Medical Records Authorization Information

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  • PDF

Size: 19 KB

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Medical Records Release in PDF

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  • PDF

Size: 384 KB

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Health Medical Release Information Form

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  • PDF

Size: 93 KB

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Medical Information Release Forms

Family Member Information Release Authorization Form

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  • PDF

Size: 33 KB

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Employee Authorization Medical Information Release

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  • PDF

Size: 69 KB

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Patient Authorization Medical Information Release

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  • PDF

Size: 85 KB

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A Clear Definition of the Parties Involved

There are typically only two parties involved in a Medical Release Form or on any other types of Release Forms for that matter. The first party is the releasor, which is the person releasing the other party from any legal liabilities or claims in the future. This could either be a patient, or a parent or legal guardian if the patient is under 18 years old.

The second party on a Medical Release Form is the releasee, which is the person or entity being released from any future legal liabilities. In the case of a Medical Records Release Form, this could be the medical care facility or medical clinic that is tasked to release the patient’s confidential health information.

In the case of a Child Medical Release Form or a Child Medical Consent Form, the releasee could be a sports organization, educational institution, church organization, or any other organizations that would require the participation of minor for their events and activities.

Legally Binding Medical Release Form

  • For a Medical Release Form to be legally binding, there has to be an explicit statement of the consent granted by the releasor to release his health and personal information to authorized parties or for the organization to facilitate the medical treatment of his child in his absence.
  • The releasor also has to be of legal age and sound mind. That means that he or she is mentally competent enough to understand the implications of signing a Medical Release Form. If it is a Medical Release Form used prior to a surgical procedure, a signed Medical Release Form means that the releasor, which in this case is also the patient, has been informed of the risks and benefits of the surgical procedures, and of any alternative treatments, if there are any.
  • The last requirement for a Medical Release Form to be legally binding is for the releasor to affix his signature on the form, along with the current date. This will show that the releasor signed the form on his own volition and that he was not forced in any way. This will also solidify the statement of the releasor’s intent to release the releasee of any future legal or financial liabilities.

A legally binding Medical Release Form means that it will hold up in court. That means that the releasee is legally protected from any claims the releasor may file in the future. One would simply need to keep records of these forms in a safe place and properly organize them so that they are easy to access when the need arises in the future.

Medical Release Authorization Forms

Medical Records Release Authorization Form

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Size: 525 KB

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Medical Information Release Authorization Form

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  • PDF

Size: 100 KB

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Protected Health Release Authorization Form

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  • PDF

Size: 260 KB

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Medical Release Information Forms

Medical Health Information Release Form

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  • PDF

Size: 83 KB

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Sample Medical Information Release Form

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Size: 60 KB

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Patient Medical Information Release Form

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Size: 57 KB

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Child Medical Release Forms

Child Medical Release

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  • PDF

Size: 116 KB

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Child Care Medical Release

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  • PDF

Size: 25 KB

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Child Emergency Medical Release

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  • PDF

Size: 53 KB

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Minor Medical Release Forms

Basic Minor Medical Release

Minor Child Medical Release

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  • PDF

Size: 43 KB

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Minor Authorization Medical Release

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  • PDF

Size: 69 KB

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Types of Medical Release Forms

There are mainly two types of Medical Release Forms featured on this article. That would be the Medical Records Release Forms or Medical Release of Information Forms, and the Child Medical Release Forms. Aside from these two, there are more types of Medical Release Forms used in the medical or health care industry, such as the use of Patient Release Forms. It is important to know the purpose of both forms so as not to confuse one with the other.

Medical Records Release Forms

To understand the importance of a Medical Records Release Form, it is important to understand the Health Insurance Portability and Accountability Act of 1996 or HIPAA. According to the long title provided by Wikipedia, the HIPAA aims to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes.

In line with this vision, the HIPAA has a privacy rule that inhibits any covered entity from releasing a patient’s health information without a written and signed consent. For this purpose, a Medical Records Release Form is used.

Covered Entities and Patient Health Information

A covered entity is any medical care facility, health insurance company, healthcare clearinghouses, or any third party company or independent contractor hired by these aforementioned entities that deal with confidential patient health information. So basically any entity that handles patient health information would need to have a signed Medical Records Release Form before they can release such information, otherwise it would be a violation of the patient’s right to privacy.

Patient Health Information includes the patient’s personal information, insurance information, health history, family history, and medical treatment and diagnosis. It is basically any information about a patient’s medical records, hence the name of the form. This would also include the patient’s health care payments, health status, and any health care provisions.

Exempted Circumstances

There are a lot of circumstances wherein a Medical Records Release Form or Medical Information Release Form can be used, but there are circumstances that do not require the consent of the patient for confidential health information to be released, especially in circumstances that would potentially jeopardize the safety of the public, or in circumstances wherein the implications are more dire than the violation of a person’s privacy.

One example of this exemption is when a hospital is required by law to disclose a patient’s confidential health information if there is potential or suspected child abuse. These cases have to be reported even without the consent of the patient, so a Medical Records Release Form would be unnecessary.

One more exemption to the HIPAA privacy rule is the release of a patient’s health information to law enforcement officials for law enforcement purposes. Various reasons include identifying a suspect, fugitive, or witness to a crime, or locating missing persons.

Summer Medical Release Forms

Summer Camp Medical Release

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Size: 12 KB

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Summer Enrollment Medical Release

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  • PDF

Size: 196 KB

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Church Medical Release

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  • PDF

Size: 74 KB

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Emergency Medical Release Forms

Emergency Medical Treatment Release Form

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  • PDF

Size: 6 KB

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Emergency Medical Care Release Form

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  • PDF

Size: 81 KB

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Emergency Contact Medical Release

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  • PDF

Size: 202 KB

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Sports Medical Release Forms

Youth Sports Medical Release

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Size: 4 KB

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Youth Medical Release

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  • PDF

Size: 73 KB

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Sports Medical Information Release Form

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  • PDF

Size: 6 KB

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Medical Work Release Form

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  • Doc

Size: 76 KB

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General Medical Release of Information Authorization Form

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  • XLS

Size: 16 KB

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Child Medical Release Forms

The other type of Medical Release Forms highlighted on this article is the Child Medical Release Form. This type of form is used by educational institutions, sports organizations, youth camps, summer camps, and other organizations that involves the participation of minors or children under the age of 18.

During school field trips or sports tournaments, there are unforeseeable events that could happen no matter how careful the faculty or organizer is. During such emergencies, it is important that the organization has a Consent Form and Release Form ready so that they can facilitate the child’s medical treatment as necessary.

If the child has to travel on his own, with only one parent or guardian, or with another adult, such as a relative, a Travel Consent Form has to be signed by the parents or legal guardians of the child. Travel Consent Forms are now required because of the increasing incidents of human trafficking and child abduction, even in the middle of custody trials.

Information to be Included on Child Medical Release Forms

  • The names, addresses, and contact information of the child’s parents or legal guardians have to be indicated so that they can be called right away in the event of an emergency. It is also advisable to include alternate contact persons, like other relatives, in case the parents or legal guardians cannot be reached.
  • The name of the minors in question should also be indicated, along with their birth dates and addresses.
  • The parents should also have a space to include the child’s health insurance information for the medical expenses to be covered by the child’s insurance policy.
  • The preferences of the parents or legal guardians when it comes to the medical care facility and/or physician also has to be stated. Although these preferences would be considered, if the child has to be urgently taken to the hospital, a closer hospital or medical care facility will be a better option. This is especially true if the event will take place at a venue that is nowhere near a medical care facility.
  • The child’s medical history can also be included to help in facilitating his medical treatment. Such information would include any present medical condition, current medication intake, vaccination history, and any present allergies to food and medication.
  • The parents or legal guardians would then have to sign and date the form for it to be official.

Along with all this essential information, there should be an explicit statement of the parent’s or legal guardian’s intent to provide consent for his child’s medical care to be facilitated by someone other than him. Aside from our Child Medical Release Forms, you may also see our sample Parental Consent Forms for more references on situations that require parental consent.

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