Authorization to Release Medical Records

This form should be completed when requesting Health Services to release your medical records we have on file.

This form allows the college to release immunization, treatment, laboratory and physical exam records as necessary.

Get in Touch

Health Services

Siek Campus Center, Suite 270
(518) 629-7468

Fax: (518) 629-7471

Office Hours
Monday - Thursday: 8 a.m. - 5 p.m.
Friday: 8 a.m. - 4:30 p.m.


Summer 2023 Hours (May 22 - July 28):
Monday – Thursday, 8 a.m. – 4 p.m.
Friday, Closed