Electronic Patient Release of Information Form


An Electronic Patient Release of Information Form is a digital document that a patient must fill out and sign to grant healthcare providers the authorization to release or disclose their health information to specified individuals or organizations. This form includes specifics about what information can be released, to whom, and for what purpose. It is a critical form used to maintain privacy and confidentiality in accordance with the Health Insurance Portability and Accountability Act (HIPAA).


Electronic: /ɪˌlɛkˈtrɒnɪk/Patient: /ˈpeɪʃənt/Release: /rɪˈliːs/of: /ʌv/Information: /ˌɪnfərˈmeɪʃən/Form: /fɔːrm/

Key Takeaways

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  1. Consent for Information Release: An Electronic Patient Release of Information Form is essentially a document that gives healthcare providers the right to share a patient’s personal health data. This could include details about the patient’s diagnosis, treatment, and overall medical condition.
  2. Security of Patient Information: With this form, healthcare providers are obligated to ensure that the patient’s details are kept confidential and shared only with authorized individuals or entities. The advancement in technology including electronic methods, provide enhanced security measures helping in safeguarding the patient’s information.
  3. Enables Coordinated Care: This form also paves the way for coordinated care, as patient information can be shared among different healthcare providers, such as specialists, nurses, and therapists, to provide the best possible treatment plan for the patient.



The term “Electronic Patient Release of Information Form” is important in the context of healthcare technology. This digital form plays a critical role in protecting patient privacy and maintaining compliance with laws such as HIPAA (Health Insurance Portability and Accountability Act). It enables healthcare providers to obtain explicit patient consent before sharing or disclosing any of their medical records or personal health information. This not only helps in upholding legal and ethical standards in patient care but also strengthens the doctor-patient relationship by fostering trust and transparency. Furthermore, as an electronic form, it streamlines the information sharing process, making it more efficient and secure for both providers and patients.


The Electronic Patient Release of Information Form is an integral part of the healthcare system, designed to facilitate the safe and efficient transfer of a patient’s medical information. It serves as a legally binding document that grants healthcare providers the permission to release a patient’s medical information to a designated third party. This could include varied data like medical history, diagnoses, lab results, treatments, and medication records. The use of electronic forms makes this process swift, secure, and more streamlined, eradicating the need for time-consuming paper-based procedures.Signing this electronic form is crucial for many reasons. It may be needed when a patient switches healthcare providers and the new medical team needs past records for a thorough understanding of the patient’s health condition. Other instances could involve legal cases where medical records are needed as evidence, participation in research, or when a patient has to substantively share his/her healthcare journey with others. With information governance and patient confidentiality being top priorities in the healthcare sector, the electronic patient release of information form ensures that these aspects are well-managed, bolstering the system’s integrity.


1. MyChart by Epic Systems: MyChart is a patient portal that many hospitals and healthcare providers use. Within this system, patients can fill out an electronic Patient Release of Information Form that allows healthcare providers to share their health information with other providers or entities. The patient can control what information is shared, who it is shared with, and for what period of time.2. Cerner Health Information Exchange: This platform by Cerner Corporation allows the seamless exchange of patient information across different healthcare systems. Patients are required to submit an electronic release form that permits their health information – such as diagnoses, medications, lab results, etc. – to be shared with other healthcare professionals involved in their care.3. Medfusion Plus App: This patient engagement app is designed to gather all of a patient’s health information into one place, even when it comes from multiple providers using different systems. To do this, the patient authorizes the release of information electronically. The app then pulls in all agreed-upon data and creates a comprehensive health overview.

Frequently Asked Questions(FAQ)

**Q: What is an Electronic Patient Release of Information Form?**A: The Electronic Patient Release of Information Form is a digital document that allows healthcare providers to share a patient’s personal health information with other entities, such as other doctors, hospitals, or the patient themself. This form must be completed and signed by the patient, as required by the Health Insurance Portability and Accountability Act (HIPAA).**Q: Why is there a need for this Electronic Form?**A: The form is necessary to maintain the patient’s privacy and allows the patient to control who can access their personal health information. By digitizing the process, it increases efficiency and convenience for both the patient and healthcare providers.**Q: How do I fill out the Electronic Patient Release of Information Form?**A: The process may vary depending on the healthcare provider’s systems, but generally, you’ll need to enter relevant details such as your name, date of birth, contact information, and details about who you’re authorizing to receive your health information, as well as the scope and purpose of the disclosure. **Q: Is my personal health information secure in an Electronic Patient Release of Information Form?**A: Yes, healthcare providers take necessary precautions to ensure your health data is protected. It is stored in secure and encrypted electronic systems. However, as with any electronic system, there may always be a small risk of data breaches.**Q: How can I withdraw or change my consent later?**A: Usually, this can be done by filling out another form indicating that you wish to revoke your previous consent. Please consult your healthcare provider for specific procedures they may have. **Q: Will my healthcare provider notify me when my health information is shared?**A: This depends on the practices of the given healthcare provider, but generally, they do not send out notifications every time information is shared based on a release form. You can discuss this with your healthcare provider if you have specific preferences or concerns.

Related Finance Terms

  • Electronic Health Records (EHR)
  • Patient Privacy Rights
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Medical Informatics
  • Health Information Exchange (HIE)

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