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Forms & Policies

Download Forms

Medical Records Release Form

Attestation on Reproductive Health Care Records

Request for Correction or Addendum for PHI

Request for Restriction to PHI

DOWNLOAD PDF (EN)

Request for Account of Disclosure

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5600 S Willow Dr. Ste. 117, Houston, TX 77035

Tel: (713) 723-5600

Fax: (713) 723-5602

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