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MEDICAL RECORDS RELEASE Patient Name:DOB:Phone #:Acct #:Email Address: All Medical Records. I,, give consent to Foothills Sports MedicinePhysical Therapy to release my medical records from ___through

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How to fill out give consent to foothills

01

Visit the Foothills website or office where the consent form is located

02

Read through the information on the consent form thoroughly

03

Fill out all required fields on the consent form accurately

04

Sign and date the consent form to indicate your agreement

05

Submit the completed consent form to the designated person or office

Who needs give consent to foothills?

01

Anyone who wishes to participate in activities or programs offered by Foothills that require consent

02

Minors may need consent from a parent or guardian

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