Forms and Instructions on How to Complete the Authorization Form:
- Download the Duke Health Enterprise Authorization for Release of Protected Health Information Form (PDF, 711 KB) in English
- Download the Duke Health Enterprise Authorization for Release of Protected Health Information Form (PDF, 313 KB) in Spanish
- View the instructions for completing the authorization form (PDF, 153 KB)
- Download the Duke Health Enterprise Verbal Release of Information Authorization Form (PDF, 516 KB)
- Download the Duke Health Enterprise Request for External Records Form (PDF, 952 KB)
- Download the Duke Health Enterprise General Authorization to DHE Providers' Access to Individual Electronic Medical Record (Maestro Care) (PDF, 675.45 KB)
- Download the Duke Health Enterprise Minor Patients (12-17 Years) Authorization to DHE Providers' Access to Individual Electronic Medical Record (Maestro Care) (PDF, 670.37 KB)
- Download the Duke University Health System Affidavit of Surviving Spouse or Next of Kin (PDF, 82.04 KB)
- Download the Duke University Health System Request for an Accounting of Disclosures Form (PDF, 39.99 KB)
Written authorization is required for medical records and must be submitted directly to the hospital’s Health Information Management department. You may mail the request to the centralized release of information department:
Duke University Hospital
Health Information Management
Release of Information
PO Box 3016
Durham, NC 27710
919-684-1700