INSTRUCTIONS   FORMS

To download a form, just click on a link below. You will need Adobe Acrobat Reader to open all files below. You can type data into any of the forms below before printing, though you cannot save that data into a PDF unless you purchased Adobe Acrobat Professional.

  Referral Form Online Form Download PDF
  WCIRB   Download PDF
  AMA/AME Rating Online Form Download PDF

Authorization Forms :

  Universal Copy HIPAA Complaint Authorization for the release of patient information   Download PDF
  Community Hospital of San Bernardino Authorization   Download PDF
  Department of Health Services County Of Los Angeles   Download PDF
  Desert Regional Medical Center Authorization   Download PDF
  Kaiser Permanente- SCPMG Authorization   Download PDF
  Little Company of Mary - San Pedro Hospital Authorization   Download PDF
  Loma Linda University Behavioral Medicine Center Authorization   Download PDF
  Pomona Valley Hospital Medical Center Authorization   Download PDF
  Presbyterian Intercommunity Hospital Authorization   Download PDF
  Quest Diagnostics Authorization   Download PDF
  Rite Aid Attorney Authorization   Download PDF
  Social Security Administration Consent for Release of Information   Download PDF
  St. Mary Medical Center Authorization   Download PDF
  UCI Medical Center Authorization   Download PDF
  UCLA Healthcare Authorization   Download PDF
  EDD Authorization For Release Of Information   Download PDF