How to complete Medical Release

There are two (2) convenient ways to use the form:

  1. Print the form and complete.
  2. Type the information on the form and then print to your printer
  1. Provide Patient Name and Date of Birth

2. “I authorize” field – Enter which medical facility you are requesting the records from.

  • Example: I authorize Lake Health Clinic or Lake District Health

3.   Purpose:  Check the box that applies to the reason you are requesting your records.

4.   To: Enter the name where the records should be sent, please complete all information n this section.

5.   Initial the records to be sent.

  • Example: Emergency room visit(s)

6.    IMPORTANT:  If you wish to send records for HIV/STI, Drug/Alcohol, Genetic Testing and Mental Health, you will need to         initial each field.

7.    Date and Sign the form. 

8.    Electronic Transmission (Email)

  • If you wish to have your records emailed to YOU, you must complete the remainder of the form
  • Make sure to initial the unsecured section
  • Provide your email address
ROI instructions

Housing Information

Like all smaller communities, Lakeview has a limited amount of housing. However, our HR staff works tirelessly to find great places for our travelers and employees to live that meets their needs. Please contact the HR department at 541-947-2114 if you are having a difficult time finding a place to live and we will attempt to help.

Visit Our Lakeview Location

700 South J Street, Lakeview, OR 97630

(541) 947-2114

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