DOWNLOAD FORMS

Please use our links below to download your authorization forms that are required when requesting a record.  To access a Medical Chart, please use the Medical Release Form.

 

Click on the link that pertains to the form that you require and it will download a form that you are required to sign in order for you to access your records.  You can either scan and upload the signed form(s) or fax it directly to RASCI’s toll free number at 800-928-2503.

 

Should you have any questions, please contact us by email at info@rasci.com or contact us at 800-971-8038. You can also use our online chat for support.

RASCI Medical Authorization Form
 
Affidavit
 
Certification
 
Attending Physician Statement