New Patient Information Packet
Authorization to Release Records TO the WCCC
Authorization to Release Records FROM the WCCC
Permission To Discuss Information With Another Party
Consent To Treat Minor Child
Temporary Guardian Authorization
When you click on the button below, a new window will appear with the Permission Form. When that window appears, click on the printer icon or select 'Print' under the File menu to send a copy to your selected printer.
TAKE ME TO THE PRINT-READY FORM