To provide consent for medical treatment, please complete the paper authorization form by clicking here. The authorization form must be legible and complete. Authorizations that are illegible or incomplete will be returned. Records are usually available within 10 days from the time the request is received. Please note that a valid signature is required on paper authorization forms. Do not use a script font to type your name.
Forms can be dropped off in person or faxed to 740-788-9226.
