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Blank Provider Release of Information English

Sonoma Superior Court · Related Links

Verified current as of July 19, 2026

This form allows a patient to give written permission for a doctor, hospital, or other healthcare provider to share their medical records with another person or organization. A patient would use this form when they need their health information sent to a lawyer, insurance company, another doctor, or anyone else involved in their case or care.

This form has fillable fields — you can complete it directly in the viewer on the right.
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