Medical Release Form
A medical release form is used to request that a healthcare provider release a patient’s medical records. Whether you’re a physician, dentist, or psychiatrist, Jotform’s free Medical Release Form template is a safe and secure way to collect sensitive medical information and electronic signatures from your patients. Rather than deal with messy paperwork, simply share your release form via email directly from your online dashboard. Patients can then fill out and sign your form from any device. Once submitted, you’ll receive a notification and finalized version of the document.
Make this Medical Release Form your own with Jotform’s intuitive drag-and-drop form builder. Upload your practice’s logo, choose fonts and colors, include additional text boxes and signature fields, edit the agreement text, and more. Once your Medical Release Form has been filled out, you can instantly download it for your records as a PDF document. Create a safe and streamlined signature experience for your patients with Jotform Sign.
Medical Records Release Authorization
Build a medical records release authorization form in seconds. Works on any device. Android and iOS compatible. Converts to a PDF. No coding knowledge required.
Online Therapy Consent Template
Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.
Doctors Note Template
Create a doctor’s note for your medical practice. Sign and send to your patients. Works on mobile, tablet, and desktop devices. Drag and drop to design.
Background Check Template
Create a custom background check form for your business. Converts into PDF. Easy to share and embed. Works on any device. Android and iOS compatible. No coding.
Professional Physical Therapy Consent Template
Create a professional physical therapy consent form. Collect e-signatures on any smartphone, tablet, or desktop. Easy to customize and share.
Hospital Discharge Template
The Hospital Discharge Template is a detailed document that provides patients with instructions and information upon discharge from a healthcare facility
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.