An Authorization Letter For Medical Records is a crucial document in the Philippine healthcare system that bridges the need for information sharing while maintaining patient privacy rights. This document is required whenever medical records need to be released to third parties, whether for continuing medical care, insurance claims, legal proceedings, or other legitimate purposes. It must comply with the Data Privacy Act of 2012 and related healthcare regulations in the Philippines. The letter typically specifies the authorizing individual's details, the records to be released, the recipient's information, and the duration of authorization. It serves as legal protection for both the healthcare provider releasing the records and the patient whose information is being shared. This document is particularly important in contexts where patient confidentiality must be balanced with the legitimate need for information access.

1. Date and Place: Current date and location where the letter is being executed

2. Recipient Details: Name and address of the healthcare facility/provider holding the medical records

3. Subject Line: Clear indication that this is an authorization for release of medical records

4. Patient Information: Complete identification details of the patient including full name, date of birth, and patient ID number if applicable

5. Authorized Recipient: Details of the person/entity authorized to receive the medical records

6. Scope of Authorization: Specific description of which medical records are authorized for release, including date ranges

7. Purpose of Authorization: Clear statement of why the medical records are being requested

8. Duration of Authorization: Validity period of the authorization

9. Patient Declaration: Statement of voluntary authorization and understanding of rights

10. Signature Block: Space for patient's signature, printed name, and date