Your privacy is one of our top priorities. Before zoomcare can request records from another healthcare provider or release your records to someone else, you may need to fill out a Release of Information Form.
Here is what you need to do:
1. Download the form that fits your needs.
- If you want your records sent to someone else then complete the "Release of Information - Send Records" form.
- If you want zoomcare to receive records from someone else, then complete the "Release of Information - Receive Records" form.
2. Print the form.
3. Fill out and sign the form.
4. Submit your form.
- Click here to submit your form via the message center.
- Email your form to email@example.com
- Mail the form to the address noted at the bottom of the form.
A note about teenage patients: Depending on the state in which you reside, teenagers age 13 to 17 may also be required to sign a release form due to certain privacy laws. If this is the case, the medical records team will contact you with further instructions once your request is received; or you can have the teenager sign the release prior to submission to ensure there are no delays in processing.