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Home » Appointments » Online Forms » Authorization for Release of Information

Authorization for Release of Information

Please Download Form and Print...

In order for us to release any of your medical information, you must sign a release form. We have made that process relatively easy by providing the form to you on this website. In order to make your visit less time consuming, we ask that you either download, print, and fill out the Authorization for Release of Information or you may type directly on the form, download, print it out and bring it to our office or to your appointment, so we can facilitate your request. Filling out this form ahead of time will enable us to serve you better and faster.

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