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A medical release form document can be used to get consent for the people in charge to submit your child for an immediate medical treatment on any hospital or medical practitioner closest to where the event is taking place. Through the hospital patient registration form, you can collect all necessary data of your patients' health related information as their name, birthday, health history, family doctor, emergency. Once completed, print, sign and date at the highland hospital health information management release of information 1000 south ave, box 55 rochester, ny 14620 phone: 5 who can sign the release form?