Get : (page 1) - Erlanger Health System

This guide provides clear instructions for completing the Release of Information form from Erlanger Health System online. Follow these steps to ensure accurate and efficient processing of your medical record request.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to access the document and open it in your editing tool.
2. In the first section, provide the name of the recipient who will receive your medical records. This could be a physician, healthcare institution, or other authorized individual.
3. Enter the email address where the electronic copy of your medical records should be sent. Ensure the address is valid to prevent delivery issues.
4. List the specific records you authorize to be released in the next field, detailing any particular dates or types of records if needed.
5. Fill in the name of the recipient's institution, if applicable, and their address, including city, state, and zip code.
6. If there is an additional recipient, repeat step 5 for the new individual or institution.
7. Provide the fax number and telephone number of the recipient if applicable, as these details may be necessary for follow-up.
8. Review all filled fields for accuracy and completeness before finalizing your submission.
9. Once completed, save your changes, and select the option to download, print, or share your completed form as needed.

Complete your document online today to ensure timely processing of your medical record request.