As a new patient, it’s important for us to have information about your health history. Please complete this form and bring it with you to your appointment. This information will be entered into your personal health information file. This information is completely confidential and only used by your team of healthcare professionals.
For you, as a patient, there are processes in place to allow you to review your medical records. Our Health Information Management team is available to assist you in obtaining a copy of your records. All patients can electronically download medical records by selecting the button below, or patients can request them from Harbin Clinic via the authorization form below.
Portions of your medical record may be available to you through a secure, online service called the Harbin Clinic Patient Portal. To sign up or learn more about visit the Patient Portal section of our website or ask a patient representative at your next visit to Harbin Clinic.
Download Authorization for the Release of Medical Records:
DownloadYou may need to authorize release of your medical records from your current doctor(s) before seeing a Harbin Clinic doctor.
Download Patient Authorization To Obtain Outside Medical Records PDF:
Download