Below is a list of medical record release forms. Should you have any questions about which one is appropriate, please feel free to contact our medical records department at (910) 323-3183 ext: 103.
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Related Documents:
PATIENT DISCLOSURE TO FAMILY MEMBER AUTH.doc
This form grants, a person of your choice access to your records.
PATIENT RELEASE FROM OTHER OFFICE.doc
This form will enable us to request your records from another facility.
PATIENT AUTHRO FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMAITON.doc
This form will enable us to share your records with another facility.
