Patient Authorization Forms and Medical Records Requests

Find the forms you need to give MinuteClinic authorization to treat a minor or to disclose health information to another provider.

Authorization to treat a minor

Authorization for release of protected health information

Authorization for release of protected health information (Spanish)

You can quickly and easily request medical records via a secure website hosted by our release of information partner, Datavant.  Just use the links below and follow the prompts.

Request records > Patients or personal representatives (including parents of minor children)   

Request records > Providers requesting records for continuity of care

Request records > All other requests including Third Party and Other Providers

These links will direct you to a third-party site (Datavant). Datavant is not owned or operated by CVS Health, MinuteClinic or any of its managed entities. Use of this site is subject to Datavant’s privacy policy and terms of use. Datavant questions call (800) 367-1500