RELEASE OF PATIENT INFORMATION SERVICES

Use this form when you need Gordon Spine Associates to release your medical records to someone else (usually another physician or insurer). If you are needing your physician to send medical records to Gordon Spine Associates, use the Medical Records Release Form instead of this form.

Just remember the following:
Medical Records Release Form -- send records to Gordon Spine Associates
Release of Patient Information Services Form -- Gordon Spine Associates send records to another physician or insurer