Template

Authorization for Medical Treatment and Release of Records

by Josh McComas, from the Community

10+

An employer-focused consent form that authorizes approved providers to deliver medically necessary treatment after an occupational injury and to release medical records to the employer. Includes fields for employee details, incident description, manager authorization, pharmacy information, and instructions for required drug and alcohol screening. Suitable for workplace health, safety, and workers' compensation documentation.

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About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

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Authorization for Medical Treatment and Release of Records

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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