--- title: Medical Release Form Template | Paperform description: Use this form to grant permission to a doctor to access your medical history. url: "https://paperform.co/templates/medical-release-form" type: static generatedAt: "2026-04-04T00:44:34.270Z" --- [← Back to free form templates](/templates/) ![Medical Release Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-release-form.png) [Preview](https://wlb01e0a.paperform.co) [Use this template for free](/create?ai-template=medical-release-form) [Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/) About this free form template ### Medical Release Form Template In most countries, doctors cannot access their patients' medical history information without patients' formal consent. To grant the consent, the patients are usually required to sign a standardized document, which is later scanned, and emailed or faxed to the institution where the medical records are being stored. If you're looking to streamline this process in your hospital, you should consider using online forms instead of traditional paper documents. We created this medical release form template below to showcase how it might look and work. The first section "Patient Contact Details" collects all the personal information of the patient that is granting the consent to the doctor. The following section "Medical Release Authorisation" asks the patient to fill out the full name of the doctor to whom the consent is given, agree to the "Authorisation and Consent Agreement", and submit an electronic signature. You might have noticed that the three last fields only appear after the first question in the second section is answered. You can easily set up this form behavior for other questions as well in the "Configure" menu. Once the authorization has been given, you might automatically generate PDF summaries of the submissions and email them to all the parties involved. Should you have any questions about Paperform, do not hesitate to contact our customer success team through the live chat in the bottom right corner. #### Key Features This template is designed to help you collect information efficiently and professionally. It includes carefully crafted questions and fields that gather all the essential details you need. #### Why Use This Template - **Save time**: Start with a pre-built structure instead of creating from scratch - **Professional design**: Looks polished and trustworthy to respondents - **Easy customization**: Modify fields, colors, and branding to match your needs - **Mobile-friendly**: Works seamlessly on all devices #### How to Use This Template 1. Click "Use this template" to import it into your Paperform account 1. Customize the questions and fields to match your specific requirements 1. Adjust the design and branding to reflect your organization 1. Share the form link or embed it on your website 1. Start collecting responses and managing submissions #### Customization Options Paperform's visual editor makes it easy to: - Add or remove questions - Change colors, fonts, and images - Set up conditional logic to show/hide fields - Configure email notifications and integrations - Accept payments if needed Get started today and create a professional form in minutes. Built for growing businesses, trusted by bigger ones. 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