Ex Parte Petition for Order to Release Medical Records {3616}

EX PARTE PETITION FOR ORDER TO RELEASE MEDICAL RECORDS. This form is filed in the Second Judicial District Court of the State of Nevada, in and for Washoe County. It is used by a self-represented individual who is the closest living relative or personal representative of the deceased person. The petitioner is seeking authorization from the court to obtain medical records of the deceased individual from specific doctors, health care providers, and medical facilities located in Nevada. The form includes details about the petitioner's relationship to the deceased, information about the deceased, names, relationships, ages, and addresses of other family members, and a request for the court to issue an order directing the specified medical entities to release the deceased person's medical records to the petitioner. The petitioner signs the document under penalty of perjury, affirming the truthfulness of the information provided. The form also contains an index of exhibits section for attaching necessary documents, such as the death certificate or other proof of death. www.FormsWorkflow.com