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Available Forms

Notice of Privacy Practices

Learn how your protected health information may be used and disclosed, as well as your rights regarding your medical information.

Download Notice of Privacy Practices

 

Release of Medical Records

Use this form to authorize the release or transfer of your medical records to or from another healthcare provider.

Download Release of Medical Records

 

Consent to Treat a Minor

This form must be completed by a parent or legal guardian when authorizing medical treatment for a minor patient.

Download Consent to Treat a Minor

 

Need Assistance?

If you have questions about any of our patient forms or need help completing them, please contact our office. Our team is happy to assist you before your appointment.

Phone: (209)755-SKIN (7546)