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SouthEast LASIK Medical Records

Medical Records
Release Authorization

SEES Icons-rgb_Style3_Forms_Medical History.png

Medical records

Authorization Form

Download >

OR
 

Click the link below to request your medical records via an online form.
Authorization for the Release of Medical Records (Online)

Your medical records include sensitive information, also known as PHI (Protected Health Information). Keeping your PHI safe is extremely important to SouthEast LASIK. Therefore, we have partnered with MediCopy, a company that specializes in pulling and delivering your medical records to you quickly and securely.

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