Patient Forms

Medical Emergency Release Form

This authorization form enables parents and guardians to authorize the provision of emergency treatment for children who become ill or injured when parents or guardians cannot be reached.

Authorization to Use or Disclose Health Information

This form enables individuals to authorize the disclosure of health record information.

Receiving Copies of Medical Test Results

This document contains information on how to receive your medical test results electronically.

Vial of Life

Bring the Vial of Life into Your Home Your Basic Medical Information Can Save Your Life. This simple, FREE Vial of Life kit has saved hundreds of thousands of lives. More than 2 million kits delivered and counting… Be smart and order your Vial of Life NOW.

Get My Free Kit