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Academic Release of Information (File: AUTH FOR RELEASE OF ACADEMIC INFORMATION.pdf)
Date Posted: 01/07/16

Blue Cross Blue Shield Authorization (File: BLUE CROSS BLUE SHIELD AUTHORIZATION.pdf)
Date Posted: 08/31/15

Dept of Veterans Affairs Authorization (File: DEPT VETERAN AFFAIRS AUTHORIZATION.pdf)
Date Posted: 08/31/15

Detroit Medical Center Authorization (File: DETROIT MEDICAL CENTER AUTHORIZATION.pdf)
Date Posted: 10/06/15

Employment Records Authorization (File: EMPLOYMENT RECORDS AUTHORIZATION.pdf)
Date Posted: 10/05/15

General Release (File: GENERAL RELEASE.pdf)
Date Posted: 08/31/15

Genesys Health System (File: GENESYS HEALTH SYSTEM.pdf)
Date Posted: 01/05/16

HealthPlus of Michigan Authorization (File: HEALTHPLUS OF MICHIGAN AUTHORIZATION.pdf)
Date Posted: 10/04/15

Henry Ford Health System Authorization (File: HENRY FORD HEALTH SYSTEM AUTHORIZATION.pdf)
Date Posted: 10/04/15

IRS 4506 - Copy of Tax Return (File: IRS 4506 - COPY OF TAX RETURN.pdf)
Date Posted: 08/31/15

IRS 4506T - Transcript of Tax Returns (File: IRS 4506T - TRANSCRIPT OF TAX RETURNS.pdf)
Date Posted: 08/31/15

Mayo Clinic Authorization (File: MAYO CLINIC AUTHORIZATION.pdf)
Date Posted: 08/31/15

Medical Records Release Form (File: AUTH FOR RELEASE OF MEDICAL RECORDS.pdf)
Date Posted: 01/08/16

Medicare Authorization (File: MEDICARE AUTHORIZATION.pdf)
Date Posted: 08/31/15

Michigan Tax Authorization (File: MICHIGAN TAX AUTHORIZATION.pdf)
Date Posted: 08/31/15

Military Medical Records Authorization (File: MILITARY MEDICAL RECORDS AUTHORIZATION.pdf)
Date Posted: 08/31/15

NPRC Military Medical Records Authorization (File: NPRC MILITARY RECORDS AUTHORIZATION.pdf)
Date Posted: 08/31/15

Order Form (File: ORDER FORM.pdf)
Date Posted: 10/06/15

Rite Aid Authorization (File: RITE AID AUTHORIZATION.pdf)
Date Posted: 10/06/15

Social Security Authorization (File: SOCIAL SECURITY AUTHORIZATION.pdf)
Date Posted: 08/31/15

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