DOWNLOAD ALL FORMS

From this page, you can download blank RECORD REQUEST and FACILITY FORMS.

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Please fill out theRECORD REQUEST FORM completely, making sure to include all reference numbers and information, then along with the signed client authorization please fax to 916-646-1946. If you have any questions, please call 916-646-1936 for assistance.

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RECORDS REQUEST FORM

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GENERAL AUTHORIZATION FOR RELEASE FORM

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KAISER AUTHORIZATION FOR RELEASE FORM (Printable)

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KAISER AUTHORIZATION FOR RELEASE FORM (Fillable)

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ST. JOSEPH AUTHORIZATION FOR RELEASE FORM

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SUTTER AUTHORIZATION FOR RELEASE FORM

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PSYCHIATRIC PATIENT RECORDS RELEASE (Printable)

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PSYCHIATRIC PATIENT RECORDS RELEASE (Fillable)

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CLAIMS FILE RELEASE AUTHORIZATION

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EMPLOYMENT RECORD RECORD RELEASE AUTHORIZATION

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MBFS AUTHORIZATION