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Get Release Of Medical Information Patient Particulars And Consent
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How to fill out the RELEASE OF MEDICAL INFORMATION PATIENT PARTICULARS AND CONSENT online
This guide provides a clear and structured approach to filling out the RELEASE OF MEDICAL INFORMATION PATIENT PARTICULARS AND CONSENT form online. By following these steps, you will ensure that all necessary information is accurately submitted, enabling the efficient processing of your medical information release.
Follow the steps to complete the form effectively:
- Click the ‘Get Form’ button to access the form and open it in your preferred editor. This will allow you to initiate the process for filling out your information.
- Begin by entering your personal details in the ‘Patient Particulars’ section. Provide your full name, NRIC or HRN, contact number, mailing address, and the period of attendance or admission at NUH.
- Indicate your gender by selecting either 'F' for female or 'M' for male.
- In the ‘Clinical Department’ field, specify the department that was involved in your care.
- Fill in the name of your attending doctor to complete the relevant section.
- Under the consent section, indicate your agreement to release your medical information by signing and dating the form. If applicable, ensure to mention any specific consent regarding HIV results.
- Complete the ‘Purpose for Release of Medical Information’ by selecting the appropriate reason for your request, and if necessary, specify any additional details required for medical reports.
- Select your preferred mode of collection for the medical information. Indicate whether you wish to collect it personally, have it posted, or emailed.
- Make sure to sign the form as the patient or have it signed by a parent/legal guardian if the patient is underage. Include the name and relationship to the patient if someone else is signing.
- Once you have filled out all necessary information, review the form for accuracy, then save your changes, and submit the form online as per the outlined submission process.
Start completing your RELEASE OF MEDICAL INFORMATION PATIENT PARTICULARS AND CONSENT form online today.
The physician should ask the patient to sign a written authorization to release this nontherapeutic information. The written permission should be dated, state to whom the information is to be released, which information may be passed on to that party, and when the permission to obtain information expires.
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