Get Forms - Texas Tech University Health Sciences Center El Paso

This guide provides you with a clear and comprehensive overview of how to complete the Forms for Texas Tech University Health Sciences Center El Paso online. Whether you are a patient seeking to authorize the release of your health information or a representative assisting someone in this process, this guide is designed to support you with step-by-step instructions.

Follow the steps to complete the patient information authorization form.

1. Click the ‘Get Form’ button to obtain the form and access it in the editor.
2. Fill out the 'Patient Information' section by entering your Texas Tech University Health Sciences Center Medical Record Number (TTUHSC MRN), your name, date of birth, address, daytime phone number, city, state, and zip code.
3. In the 'Receiving Party' area, indicate the name of the individual or organization that will receive the information. Decide whether this information will be sent to or received from them.
4. In the 'Information to be Released' section, select the type of records you wish to have released. You can choose 'Any and All records' or only specific types, such as progress notes, laboratory reports, or billing records.
5. Continue to 'Release Instructions,' and specify in what format you would like to receive the information (e.g., paper or electronic).
6. Under 'Purpose of Release,' check the appropriate reasons for needing the information, such as continuing care, disability, personal review, or legal purposes.
7. Review the sections regarding the consent for the release of sensitive information, such as mental health records and drug screening results. Indicate your approval or disapproval.
8. Sign the form by providing your printed name, signature (or that of a legally authorized person), the date, time, and name of the witness or translator, if applicable.
9. Once you have completed the form, ensure you save your changes. You may then download, print, or share the completed form as needed.

Complete your forms online today to streamline the process of managing your medical records.