Release of Medical Information Authorization
- If you require copies of your ASU Campus Health Service medical record you will need to fill out the Authorization form. Copying fees may apply.
- For those students with ongoing medical conditions or special medical circumstances, it is important for the Campus Health Service treating clinician to obtain copies of your past medical records. As a courtesy to our patients, by filling out the Authorization form, we will request copies of those records.
Instructions:
- Included with the form.
| Attachment | Size |
|---|---|
| Medical Records Release.pdf | 112.04 KB |