Release of Medical Records

Release of Medical Records

If requesting records for a minor, please note that under HIPAA (45 CFR § 164.502(g))., a parent/guardian generally has access to their child’s medical records. However, an exception is made if the minor consents to care that does not require parental/guardian consent under state law. Most providers take the position that if the minor can consent for the service, then they have the right to confidentiality and control access to and disclosure of medical records for those services. Read more on the New Mexico Department of Health’s website.

Please Complete Form Completely

I hereby request and authorize the release of medical, mental health, & substance abuse records of:

This form allows Sage Neuroscience Center to: Release and/or obtain copies of patient’s medical chart

All Releases Expire After One Year