MEDICAL RECORDS RELEASE FORMS

Accessibility Statement

We are committed to ensuring that our materials are accessible to all individuals. These forms are provided in a downloadable PDF format. If you need your medical records released to or from ERMMTC please select the appropriate form, download and fill it out. 

Our Fax number is (817) 410-9963 

If you experience any difficulty accessing, completing, or understanding the forms, or if you require assistance with it, please call 817-410-9993x114. A member of our team will be happy to assist you.

We are dedicated to providing equitable access and will make every reasonable effort to accommodate your needs.