Step 1. Download our Patient Forms:
- Legally Authorized Representative Designation
- Authorization to Disclose Health Information
- Patient Email Informed Consent
Step 2. Fax completed forms to: 256-327-9699 or email to: info@smithfamilyclinic.org*
*(If email transmittal is used outside of the Genome Gateway, an executed Email Informed Consent Form (above) must accompany the first submitted form or communication.)
