Medical Records Release Request

Medical Records Release Request

Download the Medical Records Release Form (PDF), fill it out following the included directions and send it to the Dean of Students.

You can now pay with paypal! Just fill in the name of the Alumnus/Student who is requesting the Release below and click ‘Buy Now’. Please note, you must still fill out and mail in the form. Don’t want to use paypal? You can still mail in a check with the Form.


Name of the Alumnus/Student who is requesting the Release: