Patient Privacy Practices Navigation
Release of Information
Please complete the following form if you would like us to send your records to another office or health care provider.
Please provide the name, address and phone number of the party that you would like your records forwarded to.
This form must have a witness signature to be valid.
You can also complete this form if you would like another office or health care provider to send records to Peak Orthopaedics, PLLC.
Authorization of Release of Information
Notice of Privacy Practices
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