Get Denver Health Release Form

Completing the Denver Health Release Form online allows you to efficiently authorize the release of your health information. This guide provides clear instructions to help you navigate each section of the form with confidence.

Follow the steps to successfully fill out the form.

1. Click ‘Get Form’ button to obtain the document and access it in your preferred editing tool.
2. Enter the patient's legal name in the designated field, ensuring you format it as 'Last Name, First Name'. Next, fill in the date of birth in the mm/dd/yy format.
3. Complete the address section by providing the street address, city, state, and zip code. Ensure all details are accurate for potential follow-up communication.
4. Input the social security number and telephone number in the respective fields. This information is essential for identification purposes.
5. Indicate the party to whom health information is to be disclosed by filling in their name, address, city, state, zip code, telephone, and fax number.
6. In the information to be released section, check the boxes corresponding to the types of documents you wish to obtain, such as 'Clinic Notes' or 'Laboratory Reports'.
7. If applicable, check the boxes regarding the release of information related to HIV, mental health treatment, or substance abuse. Ensure that you understand the implications of authorizing this information.
8. Select your preferred format for receiving the records, whether printed, e-mailed, saved on CD, reviewed in EHR, or posted on My Chart.
9. Specify how you wish the records to be released: mailed, faxed, or picked up. Fill in the necessary contact details as required.
10. If you wish to designate someone to receive verbal information about your treatment, fill in their name in the provided space.
11. Indicate the purpose of the records release by selecting one option, such as 'Continuing Care' or 'Legal'. If other, specify your reason.
12. Read through the authorization, understanding your rights regarding revocation of this authorization. Provide your signature and the date to finalize the form.
13. Review all entered information for accuracy. Once complete, you can save changes, download, print, or share the form as needed.

Complete your Denver Health Release Form online today to ensure your health information is handled securely and efficiently.