This medical release form template has a simple purpose, to give consent that the patient’s information can be released by their healthcare provider to someone other than the patient.
Check out the template below:
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Customize the Medical Release Form
The beauty of all WPForms templates is that they’re easy to use and fully customizable. This means you can quickly adapt this form to fit your needs.
We’ve added a signature field to the form so you can collect paperless information from patients.
You could add a section to include details for another patient, for example, if a parent or guardian fills out the form on behalf of a minor. Consider adding a Multiple Choice form field to ask the user the reason for the authorization. Finally, there’s the option to add a field stating when the authorization will end, saving you and the patient valuable time.