Get Iwk Health Centre Authorization For Release Of Health Information 2016

Completing the IWK Health Centre Authorization For Release Of Health Information form online can ensure your health records are accessed safely and efficiently. This guide provides clear instructions to help you navigate each section of the form.

Follow the steps to complete your authorization form accurately.

1. Press the ‘Get Form’ button to access and open the form in the online editor.
2. Fill in your patient identification information. Include your given name(s), last name, date of birth in the format dd/mm/yyyy, previous surname (if applicable), address, and phone number. Ensure that all details are accurate.
3. Indicate your request by checking one option: either to view the original record or to request a copy of the original record or specific documents. Make sure to denote your choice clearly.
4. Specify who the records should be released to by checking one option: either you are requesting access to your own record, or you authorize the release of information to another person or organization. Add their address, telephone number, and fax number, if applicable.
5. Clarify the records you wish to authorize for release by checking all relevant options provided in section four. If necessary, list specific records and relevant dates.
6. Review the fee schedule outlined in the form. Acknowledge the non-refundable fee to request records, which varies based on the specifics of your request.
7. Identify your relationship to the patient by checking the appropriate box, such as ‘Self’ or ‘Substitute Decision Maker’.
8. Sign and date the form where indicated, ensuring to include a photocopy of a government-issued ID if submitting the form through mail or fax. If you're delivering the form in person, be ready to present your ID.
9. If applicable, use the 'additional verification' section to help certify the identity of the applicant if they cannot provide identification.
10. Once all sections are filled out accurately, save your changes. You can download, print, or share the form as necessary.

Complete your authorization form online to ensure a smooth and secure process for accessing your health information.