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Occasionally, there is a request for release of info. Below is the process:
                                         Request for Release of Info Form
1) Please email to request a blank copy of the Release of Info form.
2) Patient can fill and sign the authorization form.
3) Please mail us the form. Fax is also acceptable. Please note the contact info below.
4) Please be aware that it can take a few weeks to send the info, once all the info is received. Please be ready to pay. And please be patient.

Note for insurance company -- If there is a request for multiple patients, please mail us info for each of the patients.

Thank you.


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