Medical Records Release and Privacy Statement

Medical Records Release and Privacy Statement

To maintain strict confidentiality for our patients, The Surgical Clinic, PLLC requires written permission from the patient before any records are released to another physician, insurance company or other person.

For your convenience print the Medical Records Release Form,  fill it out and fax or mail it to the appropriate location.  Once this form is received, copies will be sent accordingly.

Please read and be familiar with The Surgical Clinic, PLLC Privacy Practice.