Medical record release form

Over the years, many Nurses’ Health Studies participants have requested a document that they can use in the event of disability or death to inform their family and doctor about their study participation. In response to this request, the studies developed an Authorization for the Release of Medical Records form.

If you choose to complete and sign this form, please keep it with your will or other personal papers. The form will make your wishes regarding release of your medical records to the Nurses’ Health Studies known to your family and doctor in the event you are not able to personally notify the study about changes in your health status.

Please note that this form is for you to keep with your records. Do not return the form to the Nurses’ Health Study at this time.