Forms

Medical Records Requests

You may obtain a copy of your medical record created by and/or maintained by your Washington University Physicians provider by clicking here.

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)