Records Release Form

Patient Records Release Form.pdf
File Size: 67 kb
File Type: pdf
Download File
Please complete the Records Release form and return to the office via fax, USPS or drop off during regular business hours. 

*You may also fill out the records release form online and submit using the "dropbox" feature.
​The dropbox is a HIPPA compliant, encrypted and secure way to submit your patient forms and copies of your insurance card/s. 
THIS IS NOT AN EMAIL BOX. ​
​Please call the office with concerns.