We want to provide you with what you need when you need it, so we're putting some of our most requested forms online.
Release of Medical Information
Authorization for Use or Disclosure of Medical Information Form
- Complete sections A-D.
- Save file to your desktop or a safe place.
- Print Form.
- Sign and Date the form.
- Provide a readable copy of Driver’s License.
- There is no charge for physician reports and/or test results only.
- If requesting ALL documents, charges will be calculated with the request. Payment is due before records are mailed.
- Records will be mailed within 7-10 days of request, or once payment as been received.
Advanced Directives/Advance Care Planning
A Gift For Your Family. Specially trained volunteers are available to assist patients and visitors with Advance Directives. Call 755-0772 to schedule an appointment.
Medication and Allergies List
There are two vital questions your doctor must ask before treating you. Do you have any allergies and are you taking medications? It takes hardly any time at all to complete the forms that list allergies and mediations but this bit of organization might ensure your health and safety at the most critical time. Once completed, keep an updated copy of the forms in your wallet/purse so it will be available at all times. Download a Medication Safety brochure
Download a Medication List to fill out and bring with you.