TTUHSC Office of Institutional Compliance
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Lubbock Campus Forms


Authorization for Release of Patient Information

General English Version Spanish Version
Larry Combest Community Health and Wellness Center English Version Spanish Version
Ophthalmology English Version Spanish Version
Student Health Services English Version Spanish Version
Sunrise Canyon Clinic English Version Spanish Version
Psychiatry English Version Spanish Version
Grand Expectations OB/GYN English Version Spanish Version
Speech-Language & Hearing Clinic English Version Spanish Version
Pediatrics C.A.R.E. Center English Version Spanish Version
TTP OB/GYN Medical Pavilion English Version Spanish Version
Center for Perinatal Medicine English Version Spanish Version
Center for Fertility & Reproductive Surgery English Version Spanish Version
Southwest OB/GYN Associates English Version Spanish Version


Authorization for Release of Psychotherapy Notes

Medical Records English Version Spanish Version
Family Medicine English Version Spanish Version
Psychiatry English Version Spanish Version
Southwest Institute for Addictive Diseases English Version Spanish Version


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