Nephrology Medical Records Release Form

Complete Nephrology Records Release Form

Managing kidney disease requires seamless coordination between nephrologists, dialysis centers, transplant teams, and primary care providers. Our Nephrology Medical Records Release Form makes it simple for patients to authorize the transfer of comprehensive treatment records, ensuring continuity of care across all touchpoints in their kidney health journey.

Streamline Patient Records Transfer

This template is specifically designed for nephrology practices, dialysis centers, transplant programs, and kidney disease clinics that need to securely release detailed treatment records. The form captures all necessary patient information, authorization details, and specific record types—from dialysis session logs and kidney function tests to transplant evaluation status and vascular access records.

Why Paperform for Healthcare Records Management

Built for healthcare providers who need both HIPAA-conscious design and professional presentation, this form template includes:

• Patient identification and contact details with fields for referring physician information
• Comprehensive record selection options covering dialysis logs, lab results, imaging, transplant evaluations, and more
• Purpose of request tracking to document medical need and authorization scope
• eSignature capture for secure patient authorization (integrate with Papersign for advanced contract workflows)
• Conditional logic that shows relevant follow-up questions based on record type selection
• Professional medical aesthetics that inspire patient confidence

Automate Your Records Workflow

Connect this form to your practice management system using Stepper to automatically route requests to medical records departments, notify receiving providers, log requests in your EHR, and trigger follow-up reminders. Paperform's native integrations with Google Drive, Dropbox, and major CRMs mean you can build a complete records release workflow without IT support.

Trusted by Healthcare Providers

With SOC 2 Type II compliance, data residency controls, and secure submission handling, Paperform gives nephrology practices and dialysis centers the security foundation they need for sensitive patient information. Whether you're a solo practice or a multi-location kidney care network, this template adapts to your workflow while maintaining the professional standards your patients expect.

Start with this template and customize fields, branding, and automation rules to match your specific nephrology practice needs—no coding required.