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Authorization to Disclose or Release Health Information

If you want to have a medical record transferred from another doctor’s office to your new ¸Û°Äͼ¿â Medical Group office, please complete this form. Likewise, this form can also be used to authorize someone other than you to have access to information about your healthcare status on treatment. Just print and complete the form and bring it with you to your next appointment.

• Authorization to Disclose or Release Health Information

For questions about these forms, please call your ¸Û°Äͼ¿â Medical Group practice.

¸Û°Äͼ¿â Medical Group is dedicated to ensuring you understand the billing process and the resources available to you. We offer multiple ways to pay your bill - online, through the mail, on the phone, or in person at the ¸Û°Äͼ¿â Medical Group office. 

• Pay your ¸Û°Äͼ¿â Medical Group Bill

We encourage all of our patients to sign up for ¸Û°Äͼ¿â MyChart. It’s a great way to communicate with your care teams, schedule an appointment, request a prescription refill and view test or lab results – all on your own time. It also keeps you up-to-date on when you’re due for routine vaccinations or other preventative screenings so that you can be a more active – and proactive – part of your healthcare team.

One of the ways we deliver quality care is by helping connect you to additional information and resources even in between your visits to our office. Below you will find links to online resources, as well as health information and a wide-range of disease-specific support groups offered at ¸Û°Äͼ¿â.

• Health & Wellness