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Chiropractic Patient Authorization to Release Medical Records
Get this Authorization form signed in order to get access to a patient's medical records for purposes of chiropractic treatment.
- The patient's doctor or other medical service provider is directed to release the patient's medical records to the chiropractor so that treatment can begin.
- This is a generic patient authorization form that can be used anywhere.
- You can easily customize the form with your logo, office address and phone number.
- Available in MS Word format.
$2.29
Illinois Advance Health Care Directive Forms
Ensure your wishes for medical care are followed with this Advance Health Care Directive package for Illinois.
- This package of forms for Illinois contains:
- Living Will Declaration, where you can set out your wishes for life-prolonging treatments and medications,
- Declaration for Mental Health Treatment,
- Statutory Short Form Power of Attorney for Health Care, where you can appoint someone you trust as your agent to make health care decisions for you, and
- instructions and information to assist you in preparing and completing your advance directive.
- Making an Advance Directive can help to ensure that your family and your doctor know what your wishes are regarding medical treatment and life support if you are unable to communicate or make your own decisions.
- These forms are available in MS Word format and can be re-used by spouses, partners, and other family members.
- Intended to be used only in the State of Illinois.
$19.99
Parental Consent for Surgery on Minor
Get the consent of a parent for a doctor to perform necessary surgery on a child with this medical authorization form.
- The parent acknowledges having been made aware of the risks involved with the surgery.
- The parent also acknowledges that the surgeon cannot guarantee the operation will be a success.
- The parent consents to the surgery and the use of anesthetic.
- If appropriate (according to age), the minor child also signs the form.
- This is a generic legal form which is not specific to any country.
$2.29
Request for Excuse | USA
US District Court Form AO 224 is issued by the Clerk of the Court to a juror who wishes to be excused from jury duty.
- The Office of the Clerk is requesting that the juror submit the request to the Court along with the reasons they wish to be excused.
- If the reasons are because of medical conditions, a letter from the juror's doctor must be submitted.
- USA Request for Excuse, United States District Court Form AO 224 (rev 3/94).
$0.00
