We offer some of our forms in PDF format that you can download (using the free Adobe Reader software
) and print out.
If you need any of the Physical Forms filled out by your provider, please fill out the parent portion before dropping it off or emailing it to firstname.lastname@example.org
and allow us 3-5 business days to complete.
This authorizes us to obtain records form your former physician or release your records to a new physician.
This form allows us to release your medical records to your parent/parents once you turn 18 years old and must be on file for them to make appointments, request refills, or speak with our staff.
Our HIPAA Privacy Policies and Procedures
Our Regulatory Policies and Procedures