Forms and Resources

New Patient Packet

This form is for New Patients.  Please mail the completed packet to 18880 Cherry Valley Road, Tuolumne CA 95379

Release Of Information

The companies policy and procedure that will provide better understanding when requesting records or providing authorization for a 3rd party, such as another medical doctor, to be able to request records on your behalf.

PHI form for patient

This form is for any patient requesting copies of their own health information records.

Authorization To Use And Disclose PHI

This form will allow a 3rd party, whether it is another healthcare organization, a spouse, or a family member, to have access to any health records that the patient has authorized on the form.