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Last updated 2/13/2016 
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Please download, fill out, print, and bring in with you. Thank you!   25k v. 1 May 23, 2017, 5:53 AM Michael Gombatz
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HIPAA Authorization and Consent Release of Information - Please print, fill out, and bring in with you. Thanks!        4199k v. 1 Feb 27, 2017, 4:57 PM Michael Gombatz
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Please fill out and bring in with you. Thanks!       148k v. 1 Feb 27, 2017, 4:46 PM Michael Gombatz
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If required, please fill out and bring in with you. Thanks!       69k v. 1 Feb 27, 2017, 4:48 PM Michael Gombatz
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