Medical Record Release Form
To ensure we can securely release medical information to you or your practitioner, we'll need this form signed and submitted!
What is this form for?
This form is for when you would like to be sent any of your Frida medical records or need to send your information to a third party (like your specialist or primary care provider!).
We will always let you know before we send any of your information to a third party.
You can submit completed forms and request records by messaging firstname.lastname@example.org