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An Authorization Letter For Medical Records is a crucial document in Canadian healthcare administration that facilitates the legal and compliant transfer of medical information. This document is required whenever a patient's medical records need to be released to a third party, whether for continuing care, insurance purposes, legal proceedings, or other legitimate needs. It must comply with federal privacy legislation (PIPEDA) and relevant provincial health information acts. The letter typically includes patient identification details, specific description of records to be released, duration of authorization, and clear identification of the authorized recipient. It serves as proof of informed consent and protects healthcare providers when releasing confidential medical information.

1. Date and Location: Current date and place of execution of the authorization

2. Healthcare Provider Information: Complete details of the healthcare provider or facility currently holding the records

3. Patient Information: Full legal name, date of birth, healthcare number, and contact information of the patient

4. Authorized Recipient Information: Complete details of the person or entity authorized to receive the medical records

5. Scope of Authorization: Specific description of what medical records are being authorized for release, including date ranges

6. Purpose of Disclosure: Clear statement of why the records are being requested

7. Authorization Statement: Explicit statement of authorization for release of records

8. Duration of Authorization: Specification of how long the authorization remains valid

9. Patient Rights Statement: Statement of patient's right to revoke authorization and any limitations

10. Signature Block: Space for patient or legal representative signature, date, and witness if required