Forms - Academic Release of Information

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Academic Release of Information (File: AUTH FOR RELEASE OF ACADEMIC INFORMATION.pdf)
Date Posted: 01/07/16

Employment Records Authorization (File: EMPLOYMENT RECORDS AUTHORIZATION.pdf)
Date Posted: 10/05/15

General Release (File: GENERAL RELEASE.pdf)
Date Posted: 08/31/15

Medical Records Release Form (File: AUTH FOR RELEASE OF MEDICAL RECORDS.pdf)
Date Posted: 01/08/16

Order Form (File: ORDER FORM.pdf)
Date Posted: 10/06/15

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Legal-Ease Digital Imaging, LLC, PO Box 1017, Flint, MI 48501-1017 | Phone: 855-534-4003 / 810-234-7799 | Fax: 810-547-4030