Patient release of records form and information.
Clary “Authorization to release Medical Record” form
Clary Document Management is the custodian of your records for Rios Family Medicine Clinic effective October 15, 2021. Your medical records are confidential, a copy of your medical records can be made and sent only with your written permission. If you or your new physician needs a copy of your medical records, please download This form. This record retrieval service will be available for seven years beginning on October 15, 2021, and ending on October 14, 2028. Any fee for your records will be assessed in accordance with Texas Health and Safety Code 241.154.
Clary “Authorization to release Medical [...]
Adobe Acrobat document [2.2 MB]
Clary Document Management is the custodian of your records for Rios Family Medicine Clinic effective October 15, 2021. Your medical records are confidential, a copy of your medical records can be made and sent only with your written permission. If you or your new physician needs a copy of your medical records, please download This form. This record retrieval service will be available for seven years beginning on October 15, 2021, and ending on October 14, 2028. Any fee for your records will be assessed in accordance with Texas Health and Safety Code 241.154.
Clary “Authorization to release Medical [...]
Adobe Acrobat document [2.2 MB]
Important telephone numbers for in case of emergencies:
Organization | Telephone Number |
Emergency Services & Fire Department | 911 |
Centers for Disease Control and Prevention | 800-CDC-INFO (800-232-4636) |