Authorization Letter Sample to Release Information

To know what is an Authorization Letter to Release information, you must first know what is an authorization letter. An authorization letter is a written confirmation that you approve somebody to do or to have something. Let’s say you’re wife or husband has authorization for your bank account so she/he can withdraw money from it. Or you authorize someone to sign some important document in you behalf. Well an authorization letter to release information is just a different subject. It is used for releasing information, when for example let’s say you have a treatment and the doctor needs some information from you’re side to help you in the way. In order to do that you need to write an Authorization Letter to Release information to hospital authorities to allow such release of personal information.

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Contents of Authorization Letter to Release Information

To write an authorization letter to release information you need to know It’s contents. The letter has to have the sender’s name and address with state and zip code, as well as the recipients name and his address with state and zip code. A letter date is also required. After that comes the most important part, the subject of the letter in which the sender states who he authorizes, why he authorizes and what is the purpose of authorization. In the end comes the sender’s name and his signature.

Authorization Letter to Release Information Sample:

Bob Lee
My street 23
My town, zip code

DD/MM/YYYY

England Hospital
new street 23
my town, zip code

I, Bob Lee, authorize the authorities of the England hospital to release to my doctor any information he/she requires from my person files or any records. I hereby give my permission for the use of this medical information in the diagnosis and treatment of the problem. However any other use of this information will not be permitted.

Bob Lee
Signature

Authorization Letter to Release Information Format

Editable Authorization Letter to Release Information

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