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Patient Forms

The following information is designed to help patients prepare for their appointments.

To request a copy of your medical records from a non-Family Healthcare Associates provider, please print and complete the following form. (This form will authorize FHCA to receive your records from a non-FHCA provider.)

 

Authorization to Release Medical Records to FHCA
Authorization to Release Medical Records from FHCA
Authorization to Consent to Treatment of a Minor
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