Get the free Medical Record Release Form - Mission Health
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UsingthePHQ2/PHQ9(PatientHealthQuestionnaire)
ThistoolwasadaptedfromtheICD9criteriaformajordepressivedisordertohelpphysiciansaccurately
diagnoseandfollowdepressionwithoutthemoretimeconsumingstructuredclinicalinterview(SCI)
(77×sensitivityand85×specificityforthePHQcomparedto85×sensitivityand82×specificityforthe
SCI)(1).
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What is medical record release form?
A medical record release form is a document that allows the release of a patient's medical information to a third party.
Who is required to file medical record release form?
Patients or legal guardians are required to file a medical record release form in order to authorize the release of medical information.
How to fill out medical record release form?
To fill out a medical record release form, one must provide their personal information, specify the medical information to be released, and sign and date the form.
What is the purpose of medical record release form?
The purpose of a medical record release form is to authorize the release of a patient's medical information to a specified person or organization.
What information must be reported on medical record release form?
The medical record release form must include the patient's name, date of birth, the information to be released, the recipient of the information, and the purpose of the release.
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