Form 2004 Authorization for Release of Records Form for Complaints Against a Health Care Professional - Wisconsin

What Is Form 2004?

This is a legal form that was released by the Wisconsin Department of Safety and Professional Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form 2004 Authorization for Release of Records Form?
A: The Form 2004 Authorization for Release of Records Form is a document used in Wisconsin to request the release of medical records.

Q: Who can use the Form 2004 Authorization for Release of Records Form?
A: Any individual or entity that needs access to medical records in Wisconsin can use the Form 2004.

Q: Why would someone need to use the Form 2004 Authorization for Release of Records Form?
A: Someone may need to use the Form 2004 to obtain medical records for various purposes, such as filing a complaint against a healthcare professional.

Q: What information is required on the Form 2004 Authorization for Release of Records Form?
A: The Form 2004 requires information such as the patient's name, date of birth, the period covered by the records, and the purpose for which the records are being requested.

Q: Are there any fees involved in using the Form 2004 Authorization for Release of Records Form?
A: There may be fees associated with requesting medical records using the Form 2004. The fees can vary depending on the healthcare facility and the number of records being requested.