TRAUMA WORK RELEASE OF INFORMATION FORM
| Trauma Work Release of Information Form |
You can either:
If you have any questions, feel free to reach out by email.
- download the form: right click the above link (where it says Download File), choose Save Link As (and then a destination, such as your Download folder); you may need Adobe Reader on your computer (if so click here for a free download); then save it with your initials and the date (MM/DD/YR), and email it to me; OR
- just print, sign, and email me photos of the *signed* page; OR
- print, sign, and snail mail me the *signed* page (see address on the HIPAA forms themselves).
If you have any questions, feel free to reach out by email.
