• Authorization for Release of Medical Records Form
  Use your computer's keyboard to fill out each field then print and sign the form before submitting it to HFP in person or via fax or postal mail.  Please fill out completely to avoid delays. You will be contacted when records are ready and notified of any records  reproduction and optional postage costs pre-payment required.
   

• Authorization to Seek Medical Care for Minors or Wards at HFP
  If a parent or legal guardian is unable to accompany their minor child or ward to an appointment at HFP, they must complete this form and either postal mail it to us, fax it to 978-465-9004, or have it brought in at the time of appointment. Group Home facilities should additionally include a copy of the legal guardianship papers that indicate the name of legal guardian who has filled out and signed this form.
    

• Authorization to Discuss PT Billing and/or Medical Issues Letter
  Print the form, then fill it out completely before submitting it to HFP in person or via fax or postal mail.

Note: Form and letter signatures are verified against patient registration forms.  If the patient's (or minor's parent or guardian) signature is not on file, we ask that the person signing the form or letter come in person to sign, bringing  a signed photo ID.

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