Get Authorization For The Release Of Information - Vancouver General ...

This guide provides step-by-step instructions for filling out the Authorization For The Release Of Information form for Vancouver General Hospital online. Understanding how to properly complete this form ensures that your health information is shared accurately and securely.

Follow the steps to successfully complete the authorization form.

1. Click the ‘Get Form’ button to obtain the Authorization For The Release Of Information form and open it for editing.
2. In the first section, enter the name of the patient, client, guardian, or executor who is authorizing the release of information. Make sure to write the name clearly.
3. Next, provide the full name of the person or company that will receive the information. This is crucial for ensuring the information reaches the correct party.
4. Fill in the street address, city, province, postal code, and phone number of the recipient. Accurate details are essential to avoid any delivery issues.
5. Input the full name of the patient or client whose health records will be released. Ensure this is printed in full as it appears in their health documents.
6. Include the date of birth of the patient/client in the specified format (dd/mmm/yyyy) to confirm identity.
7. Provide the Personal Health Number (PHN) or Care Card number of the patient. This identifier is important for accessing the correct health records.
8. Specify the information to be released. Clearly describe the details or type of records you are authorizing for release.
9. Indicate the time period during which the information was collected. Make sure to state the starting and ending dates clearly.
10. Outline the purpose for which the information is being released, as this aids in maintaining proper accountability.
11. Sign and date the authorization at the designated area. Ensure the date is within six months of the submission request.
12. Have a witness sign the form. Include their printed name and state their relationship to the patient if applicable.
13. Once all fields are completed, save your changes. You can then download, print, or share the completed form as needed.

Complete your Authorization For The Release Of Information form online today for a seamless experience.