Medical Records Release Form

Download & Print Medical Records Release Form

MEDICAL RECORD RELEASE FORM

Denise Hill
Health Information Technician
Phone: 910-566-1266
Fax number:  910-319-2105
Email: deniseh@thedaviscommunity.org

 

Please either fax, mail, drop off the form in person. Make sure to bring identification, bring POA forms, or any court issued documentation regarding Power of Attorney, Health Care Power of Attorney, Executor of Estate, etc.

 

*Records are typically released in 1-30 days*