Medical Release Form
If you would like copies of your medical records or would like your medical records sent to another physician, please print the medical release form and fill out the form completely. Be sure to sign the form. It then can be mailed or faxed to our office. As of April 14, 2003, the privacy of your medical records has been assured by the Health Insurance Portability and Accountability Act or HIPAA. Professional Otolaryngology Associates has taken all the required steps to insure the privacy of your medical records and to be in compliance with HIPAA requirements. Our address and fax number are below.
Professional Otolaryngology Associates
Staffordshire Professional Center Bldg. A, Suite 100
1307 White Horse Road
Voorhees, N.J., 08043
Fax: (856) 346-0757