Entry Authorizing Release of Medical Records and Medical Billing Records
Ohio · Supreme Court of Ohio
This form is an official court document used to get permission from the court to release medical and billing records. It asks the court to allow medical providers to give these records to the person who files the form.
Where this fits in a case
MotionsStage: Motions
This form is used in a probate court case involving a deceased person to get permission to access medical records. The records are intended for deciding if a wrongful death, personal injury, or survivorship action should be filed.
Either party may file.
Common questions
- What is this form for?
- This form is used to ask the court for permission to get medical and billing records for a deceased person. The records are for a specific purpose related to potential legal actions. Great care is taken to keep these records private.
- Who fills out this form?
- The form is titled for the 'Applicant' and is filed in the Probate Court. It requires signatures from the Probate Judge.
- Are these records public?
- No, the form states that the medical and billing records are confidential and cannot be shown to the public unless the law or a later court order says otherwise.
Revision history
No changes recorded since we started tracking this form on October 10, 2026.
Related forms
- Probate 11.0
Consent to Power to Sell Real Estate
This form is a document where the surviving spouse and heirs of a deceased person agree to give permission for the estate's representative to sell real estate. The agreement sets rules for the sale, such as requiring the sale price to be at least eighty percent of the appraised value.
Fillable PDFMotions
- Probate 13.10
Notice to Extend Administration
This form is a notice used by the person managing an estate to tell the court that they need more time to finish the estate's business. It asks to extend the time limit beyond six months and lists the specific reasons for needing more time.
Fillable PDFMotions
- Probate 13.4
Waiver of Partial Account
This form is used to officially state that the people who are supposed to receive assets from a deceased person agree to waive a request for a partial accounting from the person managing the estate.
Fillable PDFMotions
- Probate 14.1
Waiver and Consent Wrongful Death and Survival Claims
This form allows someone to give up their right to be notified about a hearing and to agree to and approve how money from wrongful death and survival claims will be settled and given out.
Fillable PDFMotions
- Probate 20.1
Affidavit of Mental Illness
This form is an Affidavit of Mental Illness used to tell the court that someone might need to be committed because of mental illness. It asks the court to consider several specific reasons why the person might be a risk or need treatment.
Fillable PDFMotions
- Probate 20.11
Motion to Appoint Independent Expert
This form is a request asking the court to appoint an independent expert to examine a person and report their findings to that person's lawyer.
Fillable PDFMotions
- Probate 20.3
Affidavit of Refusal of Doctor's Evaluation
This form is an affidavit used to state that a person who is alleged to be mentally ill and subject to a court order refused to have an evaluation done by a psychiatrist, a licensed clinical psychologist, or a licensed physician.
Fillable PDFMotions
- Probate 21.13
Consent to Name Conformity
This form is used to show that a parent agrees to a change of name. The person signing this form agrees to the new legal name that is being asked for in the court application.
Fillable PDFMotions