Waivers and Releases

·      Release of Medical Records (Records to be sent FROM our office)

o     Please complete the entire form and forward it to our Medical Records Department.  If you have any questions about our records release policy, please call the number noted on the form.

·        Records Request (Records to be sent TO our office)

o     This form can be used if you have been instructed by the appointment scheduler to bring certain records with you for your visit.  If records have been requested by us, please forward this completed form directly to your other physician’s office.