You decide what may be shared, with whom and why.

Use this form only after a coordinator has identified the intended recipient and purpose. Do not upload records here.

Before you authorize

This authorization supports non-clinical coordination. It does not authorize China Med Links to make medical decisions, consent to treatment or share records beyond the scope you specify.

Name the exact hospital or provider
Select only the records needed
Choose a clear expiry date
Save the reference shown after submission

Patient and authority

Patient full legal namePatient email

Representative name (if applicable)Your relationship to the patient

Authorized use

Hospital or service provider authorized to receive the records

Records covered by this authorizationMedical reportsDiagnostic imagesLaboratory resultsPathology reportsPrescriptions and medication historyDischarge summaries

Purpose of sharingAuthorization valid until

Confirmation and signature

Electronic signature (type your full legal name)

Need help or a correction?

Contact privacy@chinamedlinks.com with your reference. For identity protection, we may request additional verification before changing an authorization.