Doctor Release Form

Doctor Release Form Template for England and Wales

Create a bespoke document in minutes, or upload and review your own.

4.6 / 5

4.8 / 5

Let's create your Doctor Release Form

1. Select your governing law and document type:

2. Enter your key requirements:

3. Create your document to edit, review or download

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

"I need a Doctor Release Form to authorize the release of my medical records from London Bridge Hospital to my insurance company for a claim related to my surgery in March 2025, with the authorization valid for 3 months."

Document background

The Doctor Release Form is a critical document used in healthcare settings across England and Wales when medical information needs to be shared with third parties. This form ensures compliance with the Data Protection Act 2018, UK GDPR, and medical confidentiality requirements while protecting both healthcare providers and patients. It's essential when medical records need to be transferred between healthcare providers, shared with insurance companies, or released for legal proceedings. The form typically includes patient identification details, scope of information to be released, intended recipient details, and explicit consent declarations.

Suggested Sections

1. Patient Information: Patient's full name, date of birth, address, NHS number and other identifying details

2. Doctor Information: Doctor's name, GMC number, practice details and professional information

3. Purpose of Release: Clear statement of the specific reason for information release and intended use

4. Scope of Release: Detailed description of exactly what medical information is being authorized for release

5. Recipient Details: Complete information about who is authorized to receive the medical information

6. Duration of Authorization: Specific time period for which the release authorization remains valid

7. Consent Statement: Formal statement of patient consent including acknowledgment of understanding

Optional Sections

1. Third Party Authorization: Additional section for cases where someone other than the patient is authorizing the release (e.g., for minors or patients lacking capacity)

2. Specific Exclusions: Section detailing any specific medical information that is explicitly not to be released

3. Emergency Contact Information: Alternative contact details for urgent matters or emergency situations

Suggested Schedules

1. Identity Verification Documents: Copies of identification documents used to verify the patient's identity

2. Proof of Authority Documentation: Legal documentation proving authority to act on patient's behalf, where applicable

3. Specific Records List: Detailed inventory of specific medical records authorized for release

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��ֱ�� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Relevant Teams

Relevant Roles

Find the exact document you need

Lien Release Request Letter

A formal request letter used in England and Wales to obtain the release of a lien following debt satisfaction.

����ֱ��

How a Sales & Marketing Lead uses ����ֱ�� to reduce contract drafting time by 95%

Let's create your Doctor Release Form

Authors

Alex Denne

Find the exact document you need

Lien Release Request Letter

Hair Color Release Form

Release Of Information Letter

Medical Information Request Form

Dental X Ray Release Form

Auto Lien Release Request Letter

Student Release Form

Promissory Note Release

Minor Release Form

Medication Release Form

Medical Record Request Letter

Fitness Liability Waiver Form

Image Consent Form

Audio Release Form

Therapy Release Of Information

Release Of Information Form Mental Health

Key Release Form

Data Release Form

Paycheck Release Form

Participation Waiver Form

Consent To Share Information

Medical Consent Form For Minors

Vehicle Release Form Towing

Vehicle Release Authorisation Form

Vehicle Property Release Form

Transcript Release Authorisation

Temporary Medical Permission Form

Temporary Guardian Medical Release Form

Simple Release Form

Simple Medical Release Form

Simple Medical Consent Form

Return To Work Medical Release

Release Of Medical Records To Family Members Form

Release Of Information Form For Rental History

Release Of Care Form

Release Letter Form

Protected Health Information Form

Probate Receipt And Release Form

Printable Medical Records Release Authorisation Form

Printable Media Release Form

Printable Dental Release Form

Physical Therapy Release Form

Photo Printing Rights Release Form

Permission To Use Photo Agreement

Paid In Full Release Form

Package Release Form

Military Medical Records Request Form

Mental Health Records Release Form

Medical Treatment Authorisation Form

Medical Treatment Authorisation And Consent

Medical Release Form To Return To Work

Medical Release Form For Family Members

Medical Release Consent Form

Medical Consent Authorisation Form

Licence Release Form

Legal Release Form

Letter Of Consent Medical Authorisation Form

Impound Release Form

Hospital Release Form

Hitech Release Form

Generic Printable Medical Records Release Authorisation Form

General Release Of Information Consent Form

General Medical Record Release Form

General Authorisation To Release Information Form

Employment Verification Release

Employer Release Of Information Form

Emergency Medical Treatment Authorisation Form

Emergency Medical Authorisation Form

Driving Record Consent Form

Dental Release Form

Dental Records Request Form

Dental Photo Consent Form

Dental Patient Release Form

Dental Medical Records Release Form

��ֱ��

How a Sales & Marketing Lead uses ��ֱ�� to reduce contract drafting time by 95%

�ұ�Ծ��’s Security Promise