Get Denver Skin Clinic

Completing the Denver Skin Clinic release of information consent form is a straightforward process. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by indicating whether you authorize the Denver Skin Clinic to release records to someone, or if you wish to obtain records from another physician or facility. This is done by selecting one of the two options provided.
3. In the field labeled 'Name of physician or facility', enter the name of the physician or facility from which you are requesting records or to whom you are releasing records.
4. Complete the 'Address' section with the street address, apartment or unit number (if applicable), city, state, and zip code of the physician or facility.
5. Fill out the 'Telephone' and 'Fax' numbers for the physician or facility in the respective fields.
6. Specify the 'Reason for release' by clearly stating the purpose for which the information is being requested or released.
7. Indicate the specific information you would like to be released by checking the appropriate boxes next to each type of information (History & Physical, Laboratory test reports, Consultation/Procedure reports, Pathology slides, and Pathology reports).
8. Enter your 'Patient Name', ensuring it is written clearly and accurately.
9. Provide your signature to authorize the release of information, along with your date of birth and the date you sign the consent.
10. Lastly, record the time of signing in the 'Time' field before you finalize the process. Once completed, you can save changes, download, print, or share the form if needed.

Complete your documents online today for a seamless experience.