Forms

Medical Records Request

• Request a Copy of Your Medical Records (for yourself) (PDF)
• Request Medical Records Release (to a third party) (PDF)

Consent and Communication 

• Consent to Treatment (PDF)
• Patient Communication (PDF)
• Email and Text Authorization Form (PDF)
• Telehealth Consent to Treatment: PDF; Doc

Additional Forms

• Pediatric Update (PDF)
• Missouri MSHSAA – Sports Participation (PDF)
• Illinois IHSA – Sports Participation (PDF)
• Concussion Screen (PDF)
• Vanderbilt Assessment Scales (PDF)