Get Tufts University Health Service

This guide provides a comprehensive overview of filling out the Tufts University Health Service Medical Record/Information Release Form online. Follow the instructions carefully to ensure accurate and complete submission.

Follow the steps to complete your form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Begin filling out your personal information. Provide your name, ID number, date of birth, year of entry, and graduation year. Ensure accuracy in each field to avoid complications.
3. Input your contact information under the phone and email sections. This information is crucial for communication regarding your medical records.
4. In the phone release section, indicate whether you grant permission for Health Service staff to discuss your current condition with specified individuals. Initial appropriately and provide the names if needed.
5. For medical release, indicate the specific information you authorize to be released by initialing the appropriate boxes. Make sure to include details if you require only specific records or mention any sensitive information.
6. If you will personally pick up your records, check the box provided. Fill in the details of who will receive the records if not you.
7. Complete the section requesting records from previous healthcare providers. Fill in the name, address, and contact information of the previous provider and specify the information being requested.
8. Review all entries for accuracy and completeness. Once satisfied, sign and date the form where required. Be sure to check the expiration date and fill it in as necessary.
9. Finally, save changes to the form, download a copy for your records, and print it if required. You may also share the completed form with the relevant parties.

Complete your document online to ensure timely processing of your medical information.