For your convenience the below documents are available to download and print. This will allow you to fill out your forms prior to your first appointment. Please remember to bring them with you on the day of your visit. Thank you!

Medical Records Release Form - Authorization for Release of Protected Health Information

Requested Use or Disclosure of Protected Health Information Potentially Related to Reproductive Health Care

Request for Correction and Amendment of Protected Health Information 

Request for Restriction and Limitation of Protected Health Information

Request For Accounting of Disclosure of Protected Health Information