The forms listed below are for our patients' convenience.

These forms can be downloaded by clicking on their titles. They are in the universal "PDF" format. If you don't already have the free Adobe Reader software (or Adobe Acrobat Reader), you can download it here.

HIPAA Privacy Practices

To request copies of your medical records for you or your provider: Download and complete the following form and fax it to (844)556-6970 or mail it to 13595 SW 134 Ave, Suite 209, Miami, FL 33186

Medical Records Release Form


HOME  :  SITE MAP  :  HIPAA/PRIVACY  :  CONTACT US  :  958 US Hwy 64 East, Plymouth, NC  27962  :  © 2010 by HMC/CAH Consolidated, Inc. All rights reserved

Site Development : fletchergrant.com - Powered by Kentico