Patient Forms

Below are common forms you may need.

Forms You May Need

Advance Medical Directive

Sentara Healthcare and the Sentara Center for Healthcare Ethics are offering the community the opportunity to complete their Advance Care Plan (Advance Directive) and register it, free of charge, with our national Advance Directive Registry through the U.S. Living Will Registry. Where ever you go in the United States your Advance Care Plan will be accessible by healthcare professionals when needed to guide your medical care if you are unable to communicate your wishes or make your own decisions.

Authorization for Release of Patient Records

You will need this to submit this form to request paper medical records.

Authorization for Release of Patient Records en Español

Autorización para información de salud protegida.

My Halifax Medical Record Proxy Access

Download and complete this form to obtain proxy access to another patient's My Halifax Medical Record.

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