Please click PDF links below to open the forms.
Medical Release Form (English)
Medical Release Form (Spanish)
Attestation on Reproductive Health Care Records (English)
Attestation on Reproductive Health Care Records (Spanish)
Request for Correction or Addendum for PHI (English)
Request for Correction or Addendum for PHI (Spanish)
Request for Restriction to PHI (English)
Request for Restriction to PHI (Spanish)
Request for Account of Disclosure (English)
Request for Account of Disclosure (Spanish)