Chiropractic Treatment Records Release Form

Streamline Your Chiropractic Records Transfer with Paperform

Managing patient records requests is a critical part of running a compliant chiropractic practice. Whether you're transferring care to another provider, coordinating with referring physicians, or responding to patient requests for their treatment history, having a professional chiropractic treatment records release form ensures you meet HIPAA requirements while providing excellent patient service.

This template is designed specifically for chiropractors, chiropractic assistants, and healthcare administrators who need a secure, efficient way to process medical records requests. It captures all the essential information—from patient identification and specific records requested (adjustment notes, X-ray images, progress reports) to authorization signatures and receiving provider details.

Why Paperform for Healthcare Records Management?

Paperform makes it easy to create professional, on-brand forms that work seamlessly with your practice management software. You can embed this form directly on your website, send it via email, or share a link with patients who need to request their records. All submissions are securely stored and can be automatically routed to your administrative team for processing.

Enhance your workflow even further:

• Use Papersign to collect legally binding electronic signatures on records release authorizations, creating a complete audit trail without printing a single page
• Connect with Stepper to automate what happens after a patient submits their request—automatically create tasks for your records coordinator, update your practice management system, or send confirmation emails with next steps

Built for Chiropractic Practices of All Sizes

Whether you're a solo practitioner or part of a multi-location chiropractic group, this template helps you maintain professional standards while reducing administrative burden. The form includes conditional logic to show relevant fields based on the type of records requested, ensuring patients only see questions that apply to their situation.

Paperform is trusted by healthcare providers worldwide for its ease of use, professional appearance, and SOC 2 Type II compliance. While Paperform is not HIPAA compliant, it provides the security and flexibility healthcare practices need for non-protected health information workflows like appointment scheduling, general inquiries, and initial records requests.

Get started today and transform how your chiropractic practice handles records requests—professionally, securely, and without the paperwork hassle.