For your convenience, this page contains forms for use at our office. Each is in Microsoft Word format.
Records Request (Microsoft Word file - right-click to download)
This form is used to request your xrays or records from a hospital or doctor's office. Please fill in the name and address of the provider in the "To:" section as well as the phone and fax numbers of their office. Sign and date the form at the bottom. Bring this form to our office and we will fill in the rest of the information and submit it to your provider.
Records Release (Microsoft Word file - right-click to download)
This form will authorize Correct Care Chiropractic to release your X-rays or records to another provider. Please fill out the form completely, and sign and date at the bottom. You may fax, email, or bring in the form to our office. Any copy fees must be paid before your records can be released. Most records will be ready for pickup in 24 - 48 hours.