To make sure you have what you need when you need it, we've put 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
Advanced Directives/Advance Care Planning
Specially trained volunteers are available to assist you and your family
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 medications
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.