Office of Institutional Compliance
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Permian Basin Campus Forms


Authorization for Release of Patient Information

General - Midland Clinic English Version Spanish Version
General - Odessa Clinic English Version Spanish Version
Family Medicine - Midland Clinic English Version Spanish Version
Internal Medicine - Midland Clinic English Version Spanish Version
OB/GYN - Midland Clinic English Version Spanish Version


Authorization for Release of Psychotherapy Notes

General English Version Spanish Version


Notice of Privacy Practices

Notice of Privacy Practices Handout English Version Spanish Version


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