Forms & Paperwork

Authorization Forms

Authorization for Release of Health Information form
(English / Spanish)

Protecting Your Privacy, Earning Your Trust

At Marin Community Clinics, protecting your personal health information is an essential part of providing quality care. We follow HIPAA privacy and security standards to safeguard your information, respect your confidentiality, and ensure you feel safe and supported every step of the way.

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Authorization Forms

Authorization for Release of Health Information form
(English / Spanish)