North Carolina 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 release means a program enabling the Commission to release inmates who are permanently and totally disabled, terminally ill, or geriatric.

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.

Can I view my medical records? Yes. You have a legal right to see your own records. You do not have to explain why you want to see them.

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.

3903 North Carolina Department of Health and Human Services is charged with creating policy regarding "health care facilities", and is written primarily for hospitals. According to the DHHS medical records of a facility must be maintained for at least 11 years after an adult patient's discharge.

To obtain a copy of the medical records you must request the records from the medical care provider. To provide these medical records to you, your health care provider must follow government privacy laws called HIPAA. HIPAA is the Health Insurance Portability and Accountability Act of 1996.

North Carolina General Statutes §90-411$0.75 for first 25 pages. $0.50 for pages 26-100. $0.25 for pages over 100. Minimum fee of $10.00 permitted.

NOTE: Records must be retained 11 years after last encounter at hospital. NOTE: Records must be retained 11 years after last encounter. NOTE: Records must be retained until the patient reaches 19 years of age in addition to this minimum time requirement.

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.

A medical liability waiver form is completed by medical professionals. It is used to get consent to treat a patient while also protecting themselves from liability if the patient is hurt or dies while in their care. This waiver generally also provides the patient of their privacy and legal rights.

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North Carolina Medical Release