What is it?
The HIPAA Medical Records Release Form is a HIPAA-required document saying:
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Written permission is given to share a patient’s PHI (protected health information) + medical records electronically.
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Who is receiving the PHI + medical records.
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Exactly what PHI is being disclosed - and what isn’t.
- How long the patient info can be shared.
- The patient consents to sharing their PHI + medical records.
Who needs it?
- Medical Practitioners who want to release patient records without violating HIPAA.
- Patients who want their medical records to be sent to another provider.
Client Love
Why do you need it?
Legally PHI belongs to the patient—not the medical practitioner.
The chart may be yours, but the patient’s PHI isn’t. You need permission under HIPAA to share it. This is the form you use.
- Follow HIPAA.
- Honor patient boundaries.
- Protect yourself.
- Energetically align with your heart chakra by showing care for your patients.
Legal Love™ Tip: You’ll also raise your energetic frequency by using the right form. ✨
What’s included in the DIY package?
- HIPAA Medical Records Release Form Template
- Easy-to-edit doc.
- Fill in the blank format you can use right away.
- Includes key language for GDPR + U.S. compliance.
- Plain English - no confusing legalese.
- Created with care + Legal Love™.
How does it work?
- Receive an email from us with instructions.
- Download your DIY template.
- Fill in the blanks.
- Save your changes (don’t skip this step!)
- Share it with your patients—electronically or in person - and keep a signed copy.
What's the investment?
Need more legal protection?
