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Records Release Form

If you are needing to request your records be sent to another physician, please complete the form below and email it back to us at or deliver it to our office. 

Thank you

** Please complete this form in its entirety. Failure to provide new provider information including FAX will result in a delay in your request)**

Records Release Form

We are excited to meet you!

We always have new patient forms available to complete at our office but you are welcome to print and complete these forms ahead of time to save time when checking in for your appointment!

New Patient Info Sheet

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