Consent to Release Medical Records

This Consent to Release Medical Records can be used by individuals to allow organisations to access their records, or by organisations seeking such consent.

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Last updated January 14, 2025

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Suitable for Australia

Consent to Release Medical Records

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What is a consent to release medical records?

A consent to release medical records is a document that authorises an organisation or individual to access your confidential medical information for a specified purpose.
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When should you use a consent to release medical records?

You should use this document when a third party, such as an employer or insurer, needs access to your medical records and you agree to share this information.
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What should be in a consent to release medical records?

It should include your personal details, the specific information to be released, the recipient’s details, your signature, and the date of consent.
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Frequently asked questions

Who can request access to my medical records with this consent?

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What types of information can be released using this form?

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Can I limit what information is shared?

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How do I withdraw my consent after signing?

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What are the risks of signing this consent?

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Is this consent valid across all Australian states and territories?

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What should I do after completing the consent form?

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View Sample Consent to Release Medical Records

Consent to Release Medical Records
risk level indicator at Medium level

The Legal Risk Score of a Consent to Release Medical Records Template is Medium

Our legal team have marked this document as medium risk considering:

  • The release of medical records can expose sensitive personal health information, which could be misused if not properly safeguarded.
  • Once consent is given, the scope of information released is broad, including medical history, diagnoses, and treatment details, which might be more information than the patient anticipates sharing.
  • The document allows for withdrawal of consent at any time, but it does not specify the process or immediate effect of withdrawal, potentially leading to a lag during which information could still be shared.

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