If you’re a licensed medical practitioner,
you may be asked to release a patient’s medical record
– and you don’t want to violate HIPAA.

If you’re a patient,
you may wish to have your medical records sent to another practitioner on your medical team.

For either case, The HIPAA Medical Records Release Form is the document you’ll want to use.

what is the HIPAA medical records release form?

The HIPAA Medical Records Release Form a simple document signed by a patient to give consent for the release of medical records or health information. It spells out exactly which medical records and health information may be disclosed, how long the information may be shared, and to whom – and it also includes any information that the patient does NOT want to be released..

Because HIPAA protects the confidentiality of medical records, the patient signs this form to allow for the lawful release of his/her/their medical information.

The HIPAA Medical Records Release Form helps you:

Heart BulletBuild trust when patients know that you will keep their sensitive PHI protected and you’ll respect their wishes. Your patients know that you have boundaries, and that you respect theirs.

Heart BulletFollow the law which shows respect for yourself, patients, and the law. Your energetic frequency rises because you’re acting with a clear conscience, and doing things properly. You honor yourself as you honor your patients.

Heart BulletRaise your professionalism by showing that you are serious about your patients – and their medical privacy.

why do you need it?

Protecting the confidentiality and privacy of patients’ health information and not violating the HIPAA law is crucial if you’re transferring medical records.

You’ll want the patient to sign a HIPAA Medical Records Release Form BEFORE you transfer any medical records or notes to any other practitioner or person.

what’s included?

The DIY HIPAA Medical Records Release Form includes:

  • HIPAA Medical Records Release Form Template – for you to download and complete

Heart Bullet Thorough – but simple to personalize for your business

Heart Bullet In plain English so it’s easy to understand

Heart Bullet Created with deep care and Legal Love™

  • Audio Guide to walk you through the template. You fill in the blanks and it’s ready to use! In just 35 minutes, you will learn:

Heart Bullet What it says and where to customize it

Heart Bullet How it protects you

Heart Bullet When to use it

This DIY package is designed to give you a legal template that you can customize on your own and use immediately on your site. Know that it won’t create an attorney-client relationship between us and it is not personalized legal advice, but it’s an easy way to get your HIPAA Medical Records Release Form in place quickly…with lots of Legal Love™!

can I really do it myself?

Yes, you can! Every DIY legal template is written in plain English and can be completed in 60 minutes or less.

Listen to the audio guide and follow along as I read the document aloud, and you’ll easily see where to fill in the blanks for your business.

the DIY investment?

 

1 payment of $197

Important Note:
Please note that these documents are legal templates to complete and personalize yourself. They do not create an attorney-client relationship and are not to be construed as legal advice. Always have a local attorney review any legal document that you use in your business to be sure they comply with your state and local laws. Lisa is licensed as an attorney in the State of Ohio.

Lisa helped me feel confident expanding my business and navigating an important opportunity. She was completely tuned in through the entire process, saved me thousands of dollars, understood my unique needs and helped me negotiate a beautiful deal. She is a rare and special combination of both experienced, savvy lawyer and brilliant coach.

- Rachel Madorsky, LCSW

Counselor & Relationship Expert

have questions?

Purchase a 30-Minute Power Hour with Lisa
to ask questions about the template
after you’ve completed it.
(Note that this does not include a legal review
of your document.)

want it done for you?

Don’t have time?
Apply here
to see if Lisa can help you
or can refer you to another attorney.

Lisa Fraley, JD

Holistic Lawyer®, Legal Coach®, Speaker & Author

Lisa Fraley Legal Coach LLC

lisafraley.com

All are welcome. We value and appreciate you for who you are and for your unique gifts. Our core values are based on love, kindness, inclusion and respect. We do not discriminate on the basis of race, color, religion/faith, creed, sexual orientation, gender identity, gender expression, national origin or ancestry, citizenship, military status, age, income, background or ability/disability. We are continually improving and working towards full digital accessibility for this site. This site is currently 81-92% accessible, varying by webpage. We invite you to contact us at clientlove@lisafraley.com if you need assistance with any aspect of the site. We are happy to help and we welcome you with Legal Love™.

Lisa Fraley, JD

Holistic Lawyer®, Legal Coach®, Speaker & Author

Lisa Fraley Legal Coach LLC lisafraley.com

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All are welcome. We value and appreciate you for who you are and for your unique gifts. Our core values are based on love, kindness, inclusion and respect. We do not discriminate on the basis of race, color, religion/faith, creed, sexual orientation, gender identity, gender expression, national origin or ancestry, citizenship, military status, age, income, background or ability/disability. We are continually improving and working towards full digital accessibility for this site. This site is currently 81-92% accessible, varying by webpage. We invite you to contact us at clientlove@lisafraley.com if you need assistance with any aspect of the site. We are happy to help and we welcome you with Legal Love™.