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map-pin2 16708 Bothell Everett Hwy #103, Mill Creek, WA 98012
calendar-day Book Appointment
Home ยป Records Release Form

Records Release Form

Records Released FROM Our Office
(if you would like our office to send your records to another provider, complete this form)

Records Released TO Our Office
(If you would like our office to request your records from another provider, complete this form)

Forms can be submitted via fax (425) 481-4450 or they can be dropped off at our front desk. Please do not hesitate to reach out to our staff if you have any questions!