Medical Records Release Form (Pdf: Fill & Download for Free

It's OK to post a pdf of a medical records release form that a patient can print, fill out and either bring, fax or mail to your office. Posting a completed medical records release form on your website would most likely violate HIPAA. There are secure online channels that patients and doctors can use for communications.

The law, as I understand it, favors the patient. The doctor owns the paper on which the medical record is written, but the patient owns the information.In the age of EMR the patient owns the information, you are entitled to a copy. In the world of paper records the doctor’s office is entitled to charge per page. Here is a state by state link to check the different fees allowed by each state.State Medical Records Payment RatesIn addition the office is within its rights to insist you complete a form documenting the request.If you like and respect your doctor spend a few moments thinking about what might bother him about releasing the records. It might be concern for you. Some doctors get paternalistic which I am not supporting but it’s better than cold and uncaring.So to create a paper trail and to ease the concerns may I suggest the following letter to accompany whatever official form the office requires.Dear DoctorI want to explain why I want a copy of my medical record. First off I am not working with an attorney or planning a lawsuit. I just want these records with me when I go to a doctor at the Major State Academic Medical Center Upstate (or whatever reason you have). I realize that you did not write my records in a way intended for me to read and that there is a risk I may misinterpret something you wrote. I would give you the benefit of the doubt on that score.I know paper is expensive and so it the time of your employees, so let me tell you I really only need records from June 2016 to the present and if your EMR can produce PDF copies, that would be easier. I can bring an empty thumb drive or a blank CD if that would help. If postage is inconvenient I can pick up the records in person.I want you to know that I have a high respect for your skill and experience and if that were not the case I would not want copies of this record.Please note that the release attached specifies progress notes, lab reports, xrays, other special studies and letters from other doctors about me.Also I am going to the Major State Academic Medical Center Upstate on July 20 so I would appreciate if I can pick up the records a week before that date.Did I ever get a letter like this from a patient? Rarely. But some type of nice letter is much better than a cold medical records release that provokes concern and defensiveness.

Federal law is clear in preventing medical, mental health and behavioral records from release in any form without your express permission. But while employers are terrified of the penalties imposed for improperly accessing your health information, they’re more terrified of the exposure to lawsuits and regulatory action if a business is found to have a formal policy and process that enables employment discrimination on the basis of your physical or mental health preexisting conditions. So they’re unlikely to even try, as you’d have standing to sue them if you believed their review of your health records was a factor in their choice not to hire your or end your employment.There are exceptions:If you work for for an insurer or care provider in the healthcare field, the employer can request some health information but only with your prior written consent. You have the option of declining these requests.Employment in jobs that impact or have responsibility for public safety — airline pilots, maritime vessel officers, law enforcement, critical infrastructure and so forth — have a requirement to verify your physical and mental fitness. You can’t decline the request, but they can’t review your records without your prior written consent.Certain executive roles — known as “Key Man” positions — have responsibilities that directly impact financial markets or the viability of the company, which the sudden departure or incapacitation of a “Key Man” would put the company’s market value or ability to remain in business at risk. These roles will have fiduciary requirements to prove the fitness of those holding those jobs. An example would be Elon Musk, who embodies the companies and brands he builds; his sudden departure or inability to carry out his duties would dramatically harm the market’s confidence in a Tesla without his leadership, which makes him an extreme example of a “Key Man”.For most other fields of employment:For standard, enhanced and “full spectrum” background investigations of employees and job candidates in the private sector, the answer is no: medical records, health insurance claims and any current or past medical conditions are all protected under federal laws — primarily the Privacy Rule codified under the Health Insurance Portability and Accountability Act (HIPAA), which requires your affirmative, conditional and time-limited written authorization for each specific party you authorize an entity entrusted with your health records.This applies to any derivative records like billing statements or medication orders containing your Protected Health Information (PHI) or Personally Identifiable Information (PII), as well as any record with a portion of you PHI that could allow an unauthorized party to deduct your medical conditions. Your last name, age, and date associated with a order for chemotherapy treatment would clearly reveal your treatment for cancer, since there aren’t any other health conditions that employ chemo as a course of treatment.Before any employer could access your mental health and other medical records, you would need to complete all of these steps first:Submit a written a HIPAA release for each record-holding entity (hospital, MRI facility, physical therapist, third-party medical test facility, etc.)Identify on each release who is specifically permitted to receive those recordsSelect the categories of data in health data in your medical records you wish to disclose, specifically including mental and behavioral health informationSelect which categories and records are withheld for each record-holder, specifically omitting the automatic withholding of mental health recordsSet an expiration date on those releases to define when they will become invalid that allows the investigation to complete within that timeframeAbsent that, there would be no mechanism for a background investigator to obtain your records without your prior written permission. And even with your blanket permission, notes taken during any therapy sessions or in conversation with a psychologist are not permitted to be released. The intimate and unguarded nature of those conversations prompted lawmakers to ensure mental health professionals could take detailed and inconclusive notes without worry that what they jot down could be disclosed and interpreted without knowing the context.For the Department of Health and Human Service FAQ for patients on their rights under HIPAA, Refer to 45 CFR 164.508(a)(2) to see their guidance on special protections for mental health records.Download a generic HIPAA release form (PDF) to see the level of specificity you are given in controlling your health records. Below is a sample screenshot:And for more general information, this infographic has a summary if HIPAA rights for patients: