If your healthcare provider (physician, hospital or medical facility) requires your authorization before providing TDI with any information regarding the illness or injury you are claiming benefits for, an Authorization for Release of Medical Information will be mailed to you when your claim is received in TDI. You must sign the Authorization and deliver (mail, fax or bring) it to your healthcare provider as quickly as possible so that your claim can be processed. If you do not receive the Authorization or if you need additional copies, you may download one here:

Medical Release Form (in pdf)