Fill out a Release Request Form (download a printable PDF file here)
- For Personal Use. If you are the minor’s Legal Guardian or already 18 years old ( Personal ID or DL must be presented)..
- Transferring to another Dr. ( have your new Provider request the Records for you, Free of Charge).
- For Second Opinion = Not leaving ACP, please Mark or print: ” second opinion” to avoid being discharged by mistake.
Download Form Now!
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