Unc Medical Release Form. Fill in your authorization form. You can also view your personal health records on the healthy heels portal.
Medical Records Release Form Unc
The campus health medical release of information form is used for consent to sharing previous medical encounter details with campus health or transmit your campus health records. Fill in your authorization form. University of north carolina at chapel hill. Unless otherwise revoked, this authorization will expire on the following date, event, or condition: You can also view your personal health records on the healthy heels portal. Web to release the protected health information of the patient named above to: Click here for the spanish version. Web my written revocation to the medical information management department. Unc medical information management attn: These forms can be found via the “ forms ” link on the intranet home page.
Click here for the spanish version. Web my written revocation to the medical information management department. We cannot accept an electronic signature on release of information forms. If you need your records released within 48 hours, a rush fee may be charged to release your records. Fill in your authorization form. Click here for the spanish version. Web campus health release of information form. Click here for the english release form. Web unc hospitals unc health information management attn: Web in order for medical information to be released, a written release must be signed by the requesting student. The authorization form can be obtained from any unc hospitals, unc hillsborough campus or chatham hospital, or you can download a copy from the link.
