Authorization Form
Please, print, fill-out and email it to gyncarefax@gmail.com.
Favor imprimir y completar esta forma y enviarla por correo electrónico a gyncarefax@gmail.com.
Authorization to Release Health Information Form
Please, print, fill-out and email it to gyncarefax@gmail.com.
Favor imprimir y completar esta forma y enviarla por correo electrónico a gyncarefax@gmail.com.
Authorization to Release Health Information Form