Medical Release Forms


From UHC to Another Office
If you are requesting that your medical records be released from the Urological Health Center to you or another provider, please print and complete the following form. No records will be released without the completetion of this form.
release form

From Another Office to UHC
If you are requesting that your medical records be released from another health care facility to the Urological Health Center, please print and complete the following form. The following form is needed for retrieval of your records from your previous physician.
release form