Legal Templates
Military Medical Record Request Form

Military Medical Record Request Form for the United States

Military Medical Record Request Form Template for United States

A Military Medical Record Request Form is a legally-compliant document used within the United States to request access to military service members' or veterans' medical records. The form adheres to HIPAA regulations, the Privacy Act of 1974, and Department of Defense requirements. It enables authorized individuals to obtain medical documentation while maintaining privacy and security standards established by federal law.

Your data doesn't train Genie's AI

You keep IP ownership of your information

Generate a Bespoke Document

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Download a Standard Template

Get our United States-compliant Military Medical Record Request Form

4.6 / 5
4.8 / 5
Access for free
OR

Alternatively: Run an advanced review of an existing
Military Medical Record Request Form

Let Genie AI's market-leading legal AI identify missing terms, unusual language, compliance issues and more - in just seconds.
Upload your Doc

What is a Military Medical Record Request Form?

The Military Medical Record Request Form serves as the standard mechanism for accessing military medical records within the United States healthcare system. This document is essential when service members, veterans, or their authorized representatives need to obtain medical documentation for various purposes, including continued healthcare, disability claims, or legal proceedings. The form ensures compliance with federal privacy laws while providing a standardized process for record retrieval across all military branches.

What sections should be included in a Military Medical Record Request Form?

1. Personal Information Section: Contains requestor's full name, Social Security Number, date of birth, current address, phone number, and email address

2. Service Information Section: Details of military service including branch, service dates, service number/ID, rank, and unit information

3. Records Request Details: Specific information about which medical records are being requested, including date ranges and facility locations

4. Privacy Act Statement: Mandatory statement regarding the Privacy Act of 1974 and how the information will be used

5. Authorization Section: Legal authorization and signature section for release of medical records

What sections are optional to include in a Military Medical Record Request Form?

1. Third Party Authorization: Section to be completed when someone other than the service member is requesting records, including legal representative information

2. Urgent Request Declaration: Section for indicating and justifying expedited processing due to medical necessity or legal requirements

3. Special Handling Instructions: Section for specific delivery or processing instructions when standard handling is not sufficient

What schedules should be included in a Military Medical Record Request Form?

1. Required Documentation Checklist: List of required supporting documents including ID verification requirements

2. Types of Available Medical Records: Comprehensive list of different types of medical records that can be requested

3. Instructions for Completion: Detailed guidelines for filling out the form correctly and submitting required documentation

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Linkedin in social icon imageX social icon image

Jurisdiction

United States

Publisher

Genie AI

Document Type

Release of Information Form

Sector

Data Privacy

Cost

Free to use
Relevant legal definitions
Protected Health Information (PHI)
Service Member
Veteran
Military Health Record
Electronic Health Record (EHR)
Authorized Representative
Power of Attorney
DD Form 214
Military Treatment Facility (MTF)
TRICARE
Custodian of Records
Release Authorization
Next of Kin
Disclosure
Health Care Provider
Service Branch
Active Duty
Medical Documentation
Personal Representative
Military Service Number
Records Request
Verification of Identity
Treatment Period
Medical History
Confidential Information
Clauses
Personal Information
Identity Verification
Authorization for Release
Privacy Protection
Records Specification
Purpose of Request
Data Protection
Confidentiality
Third-Party Access
Record Delivery Method
Processing Time
Fee Structure
Documentation Requirements
Certification
Restrictions on Use
Verification of Service
Medical Facility Information
Records Timeline
Emergency Request
Legal Authority
Information Accuracy
Record Format
Signature Requirements
Expiration of Authorization
Amendment Rights
Industries

HIPAA: Health Insurance Portability and Accountability Act - Federal law that protects sensitive patient health information from being disclosed without patient's consent

Privacy Act of 1974: Federal law that establishes a code of fair information practices governing the collection, maintenance, use, and dissemination of personal information

HITECH Act: Health Information Technology for Economic and Clinical Health Act - Expands HIPAA requirements and strengthens privacy and security protections for health data

National Defense Authorization Act: Annual federal law specifying the budget and expenditures of the U.S. Department of Defense, including provisions affecting military healthcare

DoD Regulations: Department of Defense specific regulations governing military medical records and their handling

MHS Policies: Military Health System policies specifically governing healthcare delivery and record management in military settings

Service-specific Regulations: Individual regulations for Army, Navy, Air Force, Marines, and Coast Guard regarding medical record management

FOIA: Freedom of Information Act - Federal law that requires disclosure of government records upon request, with certain exceptions

NARA Requirements: National Archives and Records Administration requirements for maintaining and preserving government records

DD Form 214 Requirements: Specifications for Certificate of Release or Discharge from Active Duty, often required for verification in medical record requests

E-SIGN Act: Electronic Signatures in Global and National Commerce Act - Facilitates use of electronic records and signatures in government and commerce

Government Paperwork Elimination Act: Federal law requiring federal agencies to allow individuals to submit information or transact electronically

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

No matches found.

Military Medical Record Request Form

U.S. legal document for requesting military medical records in compliance with federal privacy laws.

find out more

Employment Background Check Release Form

A U.S. legal document authorizing employers to conduct background checks on job candidates while ensuring compliance with federal and state regulations.

find out more

Phi Consent Form

A U.S. HIPAA-compliant authorization form for the use and disclosure of protected health information.

find out more

Phi Authorization Form

A U.S. HIPAA-compliant form authorizing the disclosure of protected health information to specified recipients.

find out more

Dr Work Release Form

A U.S. compliant medical document authorizing an employee's return to work with specified conditions and restrictions.

find out more

Police Vehicle Release Form

A U.S. legal document authorizing the release of an impounded vehicle from police custody to its rightful owner or representative.

find out more

Authorization For Release Of Protected Health Information Phi

A U.S. HIPAA-compliant authorization form permitting the release of protected health information between specified parties.

find out more

Form For Requesting Medical Records

A HIPAA-compliant form used in the US for requesting personal medical records from healthcare providers.

find out more

Share Medical Information Form

A HIPAA-compliant authorization form used in the United States for sharing protected health information between specified parties.

find out more

Release Of Records Request Form

A U.S.-compliant form used to request and authorize the release of records from organizations or institutions.

find out more

Release Of Information Statement

A U.S. legal document authorizing the controlled disclosure of confidential information between specified parties.

find out more

Release Form From Police Department

A U.S. legal document authorizing police departments to release official records while ensuring compliance with federal and state privacy laws.

find out more

Printable Work Release Form

A U.S. legal document authorizing an employee's return to work following medical leave, including any necessary work restrictions or accommodations.

find out more

Military Dependent Medical Records Request Form

A U.S. military healthcare system form for requesting medical records of military dependents, compliant with federal privacy regulations.

find out more

Medical Records Pick Up Form

A U.S.-compliant form authorizing the release and pick-up of medical records, ensuring HIPAA compliance and patient privacy protection.

find out more

Letter For Medical Records Request

A HIPAA-compliant formal request for medical records under U.S. federal and state laws.

find out more

Generic Dental Records Release Form

A HIPAA-compliant U.S. form authorizing the release of dental records from provider to patient or designated recipient.

find out more

Employee Photo Consent Form Gdpr

A dual-jurisdiction (US/EU) consent form for employee photo usage that complies with GDPR and US privacy requirements.

find out more

Dental Release Of Information Form

A U.S.-compliant legal document authorizing the release of dental records from a provider to specified recipients while maintaining HIPAA compliance.

find out more

CT Medical Records Release Form

A HIPAA-compliant authorization form used in the U.S. to permit the release of medical records to designated recipients.

find out more

Consent For Use And Disclosure Of Health Information Form

A U.S. HIPAA-compliant authorization form allowing healthcare providers to use and share protected health information.

find out more

Authorization To Release Rental History

A U.S. legal document authorizing the release of tenant rental history information while complying with federal and state privacy laws.

find out more

Authorization To Release Credit Information Form

A U.S. legal document granting permission to access an individual's credit report and financial information, compliant with FCRA and state privacy laws.

find out more

Authorization To Disclose Medical Information Form

A U.S. HIPAA-compliant form authorizing the release of specified medical information to designated recipients.

find out more

Authorization Release Form For Background Check

A U.S. legal document authorizing employers to conduct background checks on potential or current employees in compliance with federal and state regulations.

find out more

Athletic Medical Release Form

A U.S. legal form authorizing emergency medical treatment for athletes and providing liability protection for healthcare providers and athletic organizations.

find out more

Minor Medical Treatment Authorization Form

A U.S. legal document authorizing medical treatment for minors when parents/guardians are not present.

find out more

Medical Consent Form For Temporary Guardian

A U.S. legal document authorizing a temporary guardian to make medical decisions for a minor when the primary guardian is unavailable.

find out more

Authorization For Release

A U.S. legal document granting permission to share specified information between parties, compliant with federal and state privacy laws.

find out more

Written Authorization To Release Information

A U.S.-compliant legal document authorizing the release of specific personal information between designated parties.

find out more

Workers Comp Medical Release Form

A U.S. legal document authorizing the release of medical information for workers' compensation claims processing.

find out more

Work Release Form Hospital

A U.S. legal document providing medical clearance for employees to return to work, including any necessary restrictions or accommodations.

find out more

Veterinary Medical Release Form

A U.S. legal document authorizing veterinary professionals to provide medical treatment to an animal in the owner's absence.

find out more

Universal Medical Release Form

A HIPAA-compliant authorization form used in the United States for releasing medical records to specified parties.

find out more

Service Release Form

A U.S.-compliant legal document that confirms service completion and releases parties from related future claims or obligations.

find out more

Revocation Of Release Of Information Form

A U.S. legal document used to withdraw previous authorization for sharing personal information, compliant with federal and state privacy laws.

find out more

Release Form For Video Recording

A U.S. legal document granting permission to record and use an individual's image and likeness in video content.

find out more

Records Request Form Medical

A U.S.-compliant form used to request and authorize the release of medical records under HIPAA regulations.

find out more

Public Adjuster Release Form

A U.S. legal document that releases a public adjuster from further obligations upon completion of insurance claim services and receipt of payment.

find out more

Physician Medical Release Form

A U.S. legal document authorizing healthcare providers to release patient medical information in compliance with HIPAA regulations.

find out more
See more related templates

Genie’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; Genie’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

We are ISO27001 certified, so your data is secure

Organizational security:

You retain IP ownership of your documents and their information

You have full control over your data and who gets to see it

BlogAbout UsCareers🌎 Global Site

Templates

Contract Templates

Agreement Contract
Confidentiality Notice
Disclosure Agreement
Sale and Purchase Agreement
Sales Contract
Service Agreement

Letter Templates

Employment Letter
Experience Letter
Letter of Authority
Reference Letter
Rejection Letter
Termination Letter

Policy Templates

Compliance Agreement
Employment Policy
Health and Safety Policy
Information Security Policy
Privacy Policy
Workplace Policy

Industries

Legal Services

Limited Power of AttorneyBasic Binding Side LetterLetter of IntentNon Binding Comfort LetterContract For Employing A Salaried Partner Deed of Surrender (Lease)Templates for Lawyers

Manufacturing

Consignment ContractStandard Exclusive Distribution Agreement (UK)Intercompany Services Agreement Standard Directors Service AgreementConditions of Supply Memorandum of Understanding Manufacturing Legal Templates

Construction

Vesting CertificateLetter of Claim (Pre-Action Protocol)Tenancy at WillSection 146 Notice (Remedy Breach of Lease)Notice Of Forfeiture Of Lease By LandlordLease Report (Long Form)Construction Legal Templates

Solutions

Use Cases

Company Types

Comparisons

Business Categories

Teams

Information

© 2025 Genie AI Ltd. All rights reserved

Generate Legal Docs Free

Create your first 2 documents for free
You keep IP ownership of your information
Your data doesn't train Genie's AI
2 Docs LeftAccess Now
*No registration required