Get Mayo Clinic Forms

Filling out the Mayo Clinic Forms online ensures a streamlined process for authorizing media releases related to your medical information. This guide provides detailed instructions on how to complete the Authorization for Media Release form effectively and accurately.

Follow the steps to complete the Mayo Clinic Authorization for Media Release form online.

1. Press the ‘Get Form’ button to obtain the Authorization for Media Release form and open it for editing.
2. In the first section, enter the patient’s name and date of birth. Make sure to fill in all required fields accurately.
3. Next, provide the Mayo Clinic number assigned to the patient. This information is essential for proper identification.
4. In the section for medical conditions, clearly list the specific illnesses or medical details you authorize for disclosure to media representatives.
5. Review the authorization statement carefully. Understand that you are allowing Mayo Clinic to share your information through various media formats.
6. Sign the form in the designated area, and add the date by which you are signing. It is important that your signature matches any prior documentation.
7. If you are not the patient, fill in your relationship to the patient in the provided space.
8. Complete the contact information section, providing your daytime phone number, mailing address, city, state, and ZIP code.
9. Once all sections are filled, review the entire form for accuracy. Ensure that every required field is complete before submitting.
10. Save your changes, then download a copy if needed. You may also choose to print or share the form as per your requirements.

Complete your documents online with confidence by following these steps.