Universal Consent to Exchange Form

consenttoexchangeI have come up with some great files that I just can’t wait to share. These are for anyone to use, I give full permission for editing.

As a part of my job I do a lot of medical forms. In Social Work field placement usually the first thing you learn to do is create a release to exchange health information 😉

Often doctors get held up in being able to share information since Medical Records departments are not properly trained in HIPPA law, and lean towards the side of not sharing information. Right now between the 6 doctors and the 2 health systems the Releases of Information are a mess, and the doctors are having trouble getting to each other’s records on me. Even though both medical systems use EPIC1, one of the top Electronic Health Record programs out there, it has been a chore to link them up.

I was already editing my work’s “Release to Exchange” form I figured I would make my own! This form is HIPPA compliant and allows for release to exchange between multiple doctors, and through multiple modes. A non blinded signed copy is on the Google Drive that is set up for the doctors (they all have their own accounts). I’ll also be giving the form to each individual doctor’s office.

Feel free to download this, and use it however you would like! If you have questions on how to change the form and have it likely be accepted by your doctors office feel free to ask me!

The Files:

Share Your Thoughts

To Comment: click the lock, and when it turns green press the Submit Button.