Authorization Forms and Instructions for Medical Records

Written authorization is required for medical records and must be submitted directly to the Duke 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

Authorization Forms and Instructions

Download the Duke Health Enterprise Authorization for Release of Protected Health Information Form in English (PDF, 393 KB) and Spanish (PDF, 318 KB)
View the instructions for completing the authorization form (PDF, 508 KB)
Download the Duke Health Enterprise Verbal Release of Information Authorization Form in English (PDF, 516 KB) and Spanish (PDF, 214 KB)
Download the Duke Health Enterprise Request for External Records Form in English (PDF, 952 KB) and Spanish (PDF, 252 KB)
Download the Duke Health Enterprise General Authorization to DHE Providers' Access to Individual Electronic Medical Record (Maestro Care) (PDF, 766 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, 197 KB)

Interpreter Services

Duke Health offers a range of free language assistance services for all patients who prefer to communicate in a language other than English. Learn more about the interpreter services available at Duke Health.