Professional Medical Release Template

About this template

A professional medical release template is used in the healthcare industry to gather written authorization of the patient in order to disclose confidential medical information. Securely gather e-signatures online from any device with Jotform Sign’s free Professional Medical Release Template. Simply choose this template, customize it to suit your needs, then share it with patients via email.

Customizing this Professional Medical Release Template is easy with Jotform’s powerful online builder. Drag and drop to add or edit form fields, include additional signature fields, set up an automated signing order, upload your practice’s unique branding, and more. Once a patient has signed this document, a finalized PDF document will be automatically sent to your inbox — ready to download, print, and share. Make gathering patient consent a quick and painless process with this customizable template. To send and sign documents in seconds, customize this template and share it with Jotform Sign.

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These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.