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Click ‘Get Form’ to open the 2012 PA Medical Records Print in the editor.
Begin by entering your name in the designated field. Ensure that you print or type your name clearly for accurate processing.
Next, sign the form in the signature section. This is crucial as it authorizes the Public School Employees’ Retirement System to access your medical records.
Fill in the date of your signature to indicate when you authorized this release.
For physician’s information, confirm that the address for sending medical records is correctly listed as: Public School Employees’ Retirement System, Disability Section, 5 N 5th Street, Harrisburg, PA 17101-1905.

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