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Use the links below to access frequently used/requested forms.

Medical Records Release Forms

Radiology Films/Images Release Forms

Health Care Proxy

Authorization for 3rd Party Release

  • Authorization for Release of Protected Health Information to A Third-Party
    A request for your clinician to complete a letter or a form regarding your medical information to be sent to someone other than yourself. For example, give this form to your clinician if you are applying for FMLA and your employer requires information about your medical condition.

    Please note: This form is not needed if your medical information is given directly to you as the patient.