Release of Medical Information Form

Medical Services

• Cancer Institute
• Diabetes
• Ear, Nose and Throat
• Emergency Center
• Family Birth Center
• Heart and Vascular Institute
• Home Health Care
• Hospice Care
• Kidney Services
• Lab Services
• Lima Memorial Physicians
• Midwest Surgical Specialists
• Neonatal Services
• Occupational Health
  • Request for Services Form
  • Release of Medical Information Form
  • Workplace Wellness
• Orthopaedic Services
• Pediatrics
• Pharmacy
• Primary Care
• Pulmonary Services
• Radiology and Imaging
• Rehabilitation Services
• Renal Services
• Respiratory Services
• Sleep Center
• Social Services
• Surgical Services
• Telehealth
• Vein Care
• Women's Health