Medical Records Release Forms

Please print the Authorization to Release Health Information form, fill it out, and bring it with you to your appointment.

Choose either a Word document or a Text document as your form.

• Authorization to Release Health Information
  Word Format (For Microsoft Word)

• Authorization to Release Health Information
  Text Format (For Notepad)

Surgical Clearance Letter

Please print the Surgical Clearance Lette form, fill it out, and bring it with you to your appointment.

• Surgical Clearance Letter
  Word Format (For Microsoft Word)