Click on one of the links on the left to print off a HIPAA medical release form.
Click on form 1 to print it off, fill it out, and bring it to your doctor to release your medical records to us.
Click on form 2 to print it off, fill it out, and bring it in to us to give us authorization to send your medical records to another doctor.
Copyright © Iowa Dermatology, Inc.
Phone (641) 620-9119 | Fax (641) 613-1305
2605 Washington Street | Pella, Iowa 50219
Monday - Thursday open 7:00 am - 3:30 pm
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