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Please complete this form if you wish to authorize sutter health plus to disclose your protected. Please mail or fax a copy of this authorization form to the address or fax number shown on the. To request medical records on the behalf of the patient. Download and complete the radiology images authorization form. Request your medical record from sutter health.
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Who do you want us to request your. Request your medical record from sutter health. To request medical records on the behalf of the patient. Please complete this form if you wish to authorize sutter health plus to disclose your protected.
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Send the completed form by. Download and complete the radiology images authorization form. Please mail or fax a copy of this authorization form to the address or fax number shown on the. If you used a coupon to help with your cost share when fulfilling your prescription drugs, and we.