Kansas Medical Release

State:
Multi-State
Control #:
US-00562
Format:
Word; 
Rich Text
Instant download

Description

This Medical Release authorizes the physicians, hospital and all medical attendants to furnish full and complete medical reports and information requested by the person signing to whomever such person designates in the agreement. This authorization also includes examination of all hospital records, x-ray film and furnishing of any information including opinions. This agreement is applicable to all states.
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FAQ

Medical records are the document that explains all detail about the patient's history, clinical findings, diagnostic test results, pre and postoperative care, patient's progress and medication. If written correctly, notes will support the doctor about the correctness of treatment.

In NSW Health, clinicians can view their patient's My Health Record information in the HealtheNet Clinical Portal, which is accessed via their local electronic medical record (EMR) system. For more information about My Health Record: Visit: . Call the My Health Record Helpdesk on 1800 723 471.

The following is a list of items you should not include in the medical entry:Financial or health insurance information,Subjective opinions,Speculations,Blame of others or self-doubt,Legal information such as narratives provided to your professional liability carrier or correspondence with your defense attorney,More items...?23-Mar-2010

For medical records, call (314) 657-1548 to discuss your request with a Department of Health employee. If records are available, you will be given a time to retrieve the records from the Department of Health office at 1520 Market Street, 4th Floor, St. Louis, MO 63103. Records are $10, cash only.

Fax a request on office letterhead to 913-588-2495. Include the patient's name, date of birth, fax number and type of information needed. For after-hour emergencies, call 913-588-2454, option 1.

What is a Medical Records Release Form? A Medical Records Release Form is used to request that a health care provider (physician, dentist, hospital, chiropractor, psychiatrist, etc.) release a patient's medical records, either to the patient, a third party (such as an employer or insurance company), or both.

The patient's legal name, date of birth, gender, Social Security number, address, telephone number, guarantor, subscriber, or next-of-kin are key identifying elements that assist in establishing the proper individual.

Elements of a release formPatient information. Naturally, the release should require the patient's information so it's clear who the form refers to.Receiving party's information.Information to be shared.Purpose of the release.Expiration of authorization.Disclaimers.Date and signature.

Please call (916) 650-0490 for further information. If none of these circumstances apply, please complete the form. To continue with your request for access to your Medi-Cal records, please go to page 2 and indicate which records you wish to get a copy of.

The general rule for medical record retention is ten (10) years or, if the patient is a minor, not less than one (1) year after the patient reaches the age of majority, whichever is longer.

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Kansas Medical Release