Form MO300-1053 Authorization to Release Medical Records - Workers' Compensation - Missouri

What Is Form MO300-1053?

This is a legal form that was released by the Missouri Office of Administration - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form MO300-1053?
A: Form MO300-1053 is an authorization form used to release medical records related to workers' compensation cases in Missouri.

Q: Who uses Form MO300-1053?
A: Form MO300-1053 is used by individuals or their representatives who need to release their medical records for workers' compensation purposes in Missouri.

Q: What information is required on Form MO300-1053?
A: Form MO300-1053 requires the patient's name, address, date of birth, and contact information. It also requires the name of the healthcare provider and a description of the records being released.

Q: Is Form MO300-1053 specific to Missouri?
A: Yes, Form MO300-1053 is specific to workers' compensation cases in Missouri.

Q: Can I authorize the release of my medical records without using Form MO300-1053?
A: In Missouri, it is generally preferred to use Form MO300-1053 to ensure compliance with workers' compensation regulations.

Q: Does Form MO300-1053 require a signature?
A: Yes, Form MO300-1053 requires the signature of the patient or their authorized representative.

Q: How long does it take to process a request made with Form MO300-1053?
A: The processing time for requests made with Form MO300-1053 may vary depending on the healthcare provider and their record retention practices.

Q: Can I use Form MO300-1053 to request records from multiple healthcare providers?
A: Yes, Form MO300-1053 allows you to request records from multiple healthcare providers by providing their names and addresses.

Q: Is there a fee associated with using Form MO300-1053?
A: The Missouri Division of Workers' Compensation does not charge a fee for using Form MO300-1053, but healthcare providers may have their own fees for providing copies of medical records.