Print and complete the Authorization for Release of Health Information Form. Please submit the form along with a front and back copy of a Valid ID.
We ask that you specify what components of your medical records you wish to obtain. Often the discharge summary, operative report and history and physical contain relevant information to suit your needs.
The form must be completed, signed and dated by the patient or his/her legal representative.
Requests must be signed specifically for the release of the following information:
Psychiatric Care
AIDS/HIV
Alcohol/Drug Abuse
Genetic Testing