Section 20.96 Medical Records Authorization

• Library: Family Law 2014 Supp Forms

Authorization for Release of Medical Information

To:

You are hereby directed, authorized, and permitted to disclose to ______________ [Law Firm] all medical records in your possession or under your control relating to _______________ [Client] while your patient, confined to your institution, or under your care and attention and to permit said attorney to make photocopies or other copies of any of the records as may be desired. These records are to include, but not be limited to, the full and...