DHC HIPAA Release of Information to External (Outgoing_GRM)

The Diamond Headache Clinic has partnered with GRM Document Management for medical record requests to authorized third parties. To initiate a request, please complete the form below. Remember to include a current mailing address with your request, as medical records cannot be faxed. Upon completion, please mail or fax the authorization form to the GRM Document ROI Department. If you wish to determine the status of your request, please contact GRM Document ROI customer service at the number shown on the form.