Authorization to Release Medical Records
A PIPEDA-compliant authorization allowing a healthcare provider to release your medical records to a named third party.
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An authorization to release medical records is a written consent form permitting a healthcare provider — a physician, hospital, clinic, or other regulated health professional — to disclose your personal health information to a named third party. In Canada, health information is protected by provincial privacy legislation (such as PHIPA in Ontario, FOIPPA in British Columbia, and PHIA in Nova Scotia), as well as PIPEDA, and cannot be released without proper authorization.
Common uses
This authorization is typically used when: applying for life or disability insurance that requires a physician's report; providing medical records to a specialist or new healthcare provider; sharing records with an employer's occupational health department; providing evidence in a personal injury or disability claim; or responding to a court order for medical evidence.
What it must include
A valid authorization must clearly identify the patient; the healthcare provider being authorized to release information; the recipient of the information; the specific records being released (a blanket release of all records may not be acceptable); the purpose of the release; the expiry date of the authorization; and the patient's signed consent.