Get Release Of Information From Student Health Center - Tarleton State ... - Tarleton

Filling out the Release Of Information form from the Student Health Center at Tarleton State is an essential process for obtaining your medical records. This guide will take you through the steps needed to accurately complete the form online and ensure your information is properly released.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to access the Release Of Information form. This will allow you to view and edit the form for your needs.
2. In the first field, provide your first name. Enter your middle name (if applicable) and last name, including your maiden name if you have one. Make sure to fill these fields accurately to prevent any issues with your record retrieval.
3. Next, enter your Social Security Number in the designated field. This is crucial for properly identifying your medical records.
4. Enter your date of birth in the specified format. This ensures that the records can be matched correctly with your identity.
5. Identify the recipient of your medical records by entering their name in the provided space. Ensure this is accurate to ensure timely processing.
6. Indicate your preference for how the information should be sent, either by FAX or another method, if applicable.
7. Review the statement regarding the authorization period, which is in effect for six months from the date you sign. Ensure you understand that you can revoke this authorization at any time by submitting a written request.
8. Sign the authorization in the designated area as the client. Include the date of your signature to validate the request.
9. Provide the date of expiration for the release, understanding that it will automatically expire after six months unless revoked.
10. Once all fields are filled out, review the form for accuracy. You may then save changes, download, print, or share the completed form as needed.

Take action today and complete your form online to ensure your medical records are released promptly.