Form DL-22 Authority to Release Confidential Medical Report and Release of Claim - North Carolina

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form DL-22 for the current year.

Form DL-22 Authority to Release Confidential Medical Report and Release of Claim - North Carolina

What Is Form DL-22?

This is a legal form that was released by the North Carolina Department of Transportation - Division of Motor Vehicles - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form DL-22?A: Form DL-22 is the Authority to Release Confidential Medical Report and Release of Claim form used in North Carolina.

Q: What is the purpose of Form DL-22?A: Form DL-22 is used to authorize the release of confidential medical information and release any claim related to a medical condition or disability.

Q: Who needs to fill out Form DL-22?A: Form DL-22 needs to be filled out by individuals who want to release their confidential medical information and waive any claim they may have related to a medical condition or disability.

Q: Do I need to include any documents with Form DL-22?A: No, you do not need to include any additional documents with Form DL-22.

Q: Is there a fee to submit Form DL-22?A: No, there is no fee to submit Form DL-22.

Q: Who should I contact if I have questions about Form DL-22?A: If you have any questions about Form DL-22, you can contact the North Carolina Division of Motor Vehicles (DMV) for assistance.

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Form Details:

  • Released on January 1, 2017;
  • The latest edition provided by the North Carolina Department of Transportation - Division of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DL-22 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the North Carolina Department of Transportation - Division of Motor Vehicles.

Download Form DL-22 Authority to Release Confidential Medical Report and Release of Claim - North Carolina

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