Download and complete our Authorization for Disclosure of Medical Information Form. The completed and signed Authorization can be emailed to

  • When filling out the record release, please include an email address to where you would like your x-rays to be sent, along with a physical address for notes. Please allow 30 business days for us to process your request.
    • Please note: when the Dental Service sends you x-rays electronically through a secure email (KiteWorks), you must open the email within two weeks before it expires.