Shauna K 2026

1. Click ‘Get Form’ to open the Shauna K document in the editor.
2. In the first section, enter your name and date of birth where indicated. This information is crucial for identifying your medical records.
3. Next, specify whether you are authorizing the release of your medical records TO or FROM a doctor by selecting the appropriate option.
4. Fill in the doctor's name, address, phone number, and fax number in the designated fields to ensure accurate communication.
5. Indicate which specific medical records you wish to request by checking the relevant boxes. Options include complete medical records, consultation reports, allergy test/treatment details, biopsy reports, lab reports, and surgical procedures.
6. Finally, sign and date the form at the bottom. Print your name clearly to finalize your authorization.

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