Requesting patient records

To receive patient records from another healthcare provider, we first require patient consent. The patient must complete a Records Release form

At Bite please download and send a copy of this form.

At TSD, please download and send a copy of this form.

• Ask the patient to fill out all relevant information on the form

• Scan and rename the form to reflect the patient’s name, DOB and that it is a records release request

• Open MediRef, and search the provider/practice to retrieve their email address 

• Email the completed Authority to Release form to the provider/practice, including the patient’s full name and DOB in the bulk of the email so they can be easily located 

  • E.g. “Please find attached a signed Authority to Release form for patient FirstName LastName (DOB ddmmyyy)”

• Different providers/practices may use different means to share patient records, and may not always come through the MediRef system we use 

• Make a note in the patient’s file that the Authority to Release form has been sent