Through the Horses Eyes

FORMS

 


Authorization to Release Information

This authorization must be completed by the patient or his/her personal representative to use/disclose protected health information,
in accordance with State and federal laws and regulations. A separate authorization is required to use or disclose confidential HIV
related information.

Link to download PDF Authorization to Release Information

 


Referral Form 2012

Form Description to come

Link to download PDF Referral Form 2012


Form 3 Name

Form 3 Description

Link to live form and/or download PDF Form 3


Form 4 Name

Form 4 Description

Link to live form and/or download PDF Form 4

 


Form 5 Name

Form 5 Description

Link to live form and/or download PDF Form 5