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Universal Authorization Form

The Universal Authorization (UA) is for patients to complete to allow Geisinger to share his or her Geisinger medical information with any healthcare provider who is involved in his or her healthcare. For example, his or her primary care provider could review his or her medical history, lab results and medications.

You may complete the UA form by downloading the Universal authorization for the release of medical information and mailing to Geisinger Health System Medical Reports or by completing the online form.

If you would like to complete the online form and you are:

  • 18 or older
  • A current Geisinger patient
  • Have received care at a Geisinger facility previously

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