Masks still required. We provide medical masks or bring your own KN95/N95.
Masks still required. We provide medical masks or bring your own KN95/N95.
Please download and complete this form to authorize us to release your medical information to a specified party (i.e. Insurance company or laywer).
Once completed, please mail or bring the original copy to the clinic personally.
With respect to patient privacy and confidentiality, please do not email the completed form as email is not the preferred method of communication for security reasons.
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