Forms with York Medical Clinic in York, NE
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Registration Form for New Patients- Print and complete this form prior to your appointment to save time when checking in.
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Authorization to Release Records - Use this form if you want York Medical Clinic to get your records from another doctor.
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Authorization to Release Records - Use this form if you want York Medical Clinic to send your records to another doctor or facility or if you need a copy for yourself (charges may apply.)
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HIPPA Form- Use this form if you want to give someone else access to your records. (ex. a child, a friend, your POA)
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