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Format |
Form |
When to use this |
|---|---|---|
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You want Health Services to share records OR you want to request a provider share records with Health Services |
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Authorization for the Release of Health Information: Campus Partners |
You want Health Services to be able to disclose information to Counseling, Academic Deans, Athletics, or Disability Services |
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Authorization for Release of Protected Health Information: Cooley Dickinson Hospital |
You want Cooley Dickinson to release information to Health Services |
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Send an email to medical-records@mtholyoke.edu |
If you have records you'd like to share with Health Services, our staff can upload to your chart and send them to your MHC PCP |
