Release of Information

 

Print this form and complete ONLY THE HIGHLIGHTED SECTIONS so VECTOR can SEND medical records TO another provider. Please write legibly and only complete the highlighted portions. Once you have completed the document, you can email it to info@vectorhealthnwa.com or bring it to the clinic before 11/25/25. Once received, we may reach out to verify/clarify any necessary information.​

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​Medical Records Policy/Consent

For patients wanting copies of their own medical records.