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Medical Records

Medical Records

If you would like to request a copy of your medical records for yourself or for another agency/person, please complete the Authorization for Release of Protected Health Information form and return it by mail or fax to the contact information listed on the form.

 

Authorization for Release

Authorization for Release of Protected Health Information (English)

Autorizacion para la Divulgacion de la información médica protegida (PHI, en ingles)

 

Authorization for Release of Psychotherapy Notes

Authorization For Release Of Psychotherapy Notes

Autorizacion para Divulgar Notas de Psicoterapia

 

Joint Comission