Medical Records

Medical Information Documents

The following documents regarding medical information are available for download:

• Medical Record Release Information
• Low Vision Medical Record Release Information
• Pupillary Distance Release Statement
• HIPAA Statement
• Nondiscrimination Statement
• Patient Rights and Responsibilities
• Privacy Statement
• Confidential Communication Request
• Privacy Complaint
• Request to restrict uses and disclosures of personal health information (PHI)
• Accounting Request
• Consultation Request