On occasion, you may be asked to complete and return a form to Westgrove Clinic. Below are some of those forms that we regularly use in the office.
Description of forms:
- Consent to Disclose Health information - Use this form when you are authorizing another person or entity to have access to your health information (i/e family member or insurance company)
- Email Communication Consent Form - Use this form to authorize the use of electronic communication with your doctor and clinic support staff
- Request for Personal Health Records - Use this form to request a copy of your own health records.
Please note: if you are requesting a large amount of information there is a $25 fee for the preparation of your heath records.