Make a Request - Patient Care Reports Resolution for Establishing a Policy for Requests for Public RecordsHIPAA Authorization to Release Medical Information Your Name (required) Phone Your Email (required) Date Requested (mm/dd/yyyy) (required) I have read Resolution No. 2018-09 (linked above) (required)Yes Detailed Description of Records Requested Please upload completed HIPAA Authorization to Release Medical Information (linked above) There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
