• Introduction:

    Before submitting your request to obtain your medical records from Public Health Clinic, please read the instructions below carefully.

    Please complete an Authorization for Release of Health Information form. Fields marked with asterisks are required.

    You must include a copy of all necessary supporting documentation with your request; otherwise, your request cannot be processed.

Authorization For Release of Health Information

Before submitting your request to obtain your medical records from Public Health Clinic, please read the instructions below carefully.

Please complete an Authorization for Release of Health Information form. Fields marked with asterisks are required.

You must include a copy of all necessary supporting documentation with your request; otherwise, your request cannot be processed.

Gloved hands use a tablet displaying a digital health dashboard on a clinic desk, beside a stethoscope and potted plants; modern, calm setting.