HIPAA-Compliant Release of Information (ROI) Form – Customizable Template

Ensure Secure and Hassle-Free Medical Record Requests
 
Streamline patient information requests with our HIPAA-Compliant Release of Information (ROI) Form, designed for healthcare providers, clinics, and telehealth practices. This professional, easy-to-use template ensures smooth authorization for the disclosure of patient records while maintaining compliance with privacy regulations.
 
Key Features:
✅ Fully Customizable – Add your practice’s name, logo, and contact details
✅ HIPAA & Legal Compliance – Meets federal privacy and security standards
✅ Patient-Centered Design – Simple, clear, and easy for patients to complete
✅ Covers All Information Types – Includes general records, lab results, mental health, substance use, and HIV/AIDS treatment (with separate consent)
✅ Flexible Authorization Options – Patients can specify recipients, purpose, and expiration date
✅ Digital & Printable – Use it as a physical document or integrate it into your EHR system
 
Perfect For:
✔ Medical Practices & Clinics
✔ Telehealth Providers
✔ Mental Health & Behavioral Health Professionals
✔ Physical Therapy & Wellness Centers
✔ Substance Use Treatment Programs
✔ Home Healthcare Services
 
💡 Save Time & Reduce Errors – Our ready-to-use template helps providers maintain compliance while ensuring smooth, secure patient information exchanges.
 
📥 Instant Download – Get immediate access to your customizable ROI form today!