Get Records Release-pyramid Health Center

Filling out the RECORDS RELEASE form is a crucial step in authorizing the transfer of your health information. This guide provides clear and supportive instructions to help you navigate the process online with ease.

Follow the steps to complete your records release smoothly.

1. Click the ‘Get Form’ button to access the RECORDS RELEASE form. This allows you to open the document in an online editor for easy filling.
2. In the first section, enter the name of the patient in the designated field. Ensure accurate spelling for proper identification.
3. Next, input the patient's date of birth in the specified area. This information helps verify the identity of the patient.
4. Authorize the release of information by filling in the 'FROM' field with 'Pyramid Health Center' as the facility or physician's name.
5. In the 'To' section, enter the name of the facility or physician who will receive the records. Be precise to avoid any delays in processing.
6. Provide the complete address, including city, state, and zip code, for the receiving party to ensure successful delivery of the records.
7. Insert the phone number or fax number of the receiving party in the corresponding field to facilitate communication if needed.
8. Specify the reason for the release of records, selecting 'Transfer of Care' from the options available.
9. Set the expiration date for the authorization, which can be left blank for 90 days from the date signed or filled in with a specific date.
10. Review the section indicating understanding of potential risks involved in the release of medical information. Ensure you are comfortable with this acknowledgment.
11. Sign the document in the space provided for the patient's signature, followed by the date of signing. If applicable, include the signature of a guardian or representative.
12. Lastly, if a witness is required, have them sign in the designated area along with the date. Review all entries for accuracy before proceeding.
13. Once complete, you can save your changes, download the completed form, print it, or share it as needed.

Complete your records release online today for efficient management of your health information.