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MIDWIVES
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RESOURCES
PREGNANCY
Prenatal Care
Prenatal Education and Support
Pre-eclampsia Self-Screening
POSTPARTUM
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MENTAL WELLNESS
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CONTACT US
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REQUEST A MIDWIFE
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Welcome to Lincoln Community Midwives
HOME
HISTORY
MIDWIVES
Administrative Staff
Midwifery Students
CARE
BIRTHPLACE
FAQS
COVID-19
COVID POLICIES
RESOURCES
PREGNANCY
Prenatal Care
Prenatal Education and Support
Pre-eclampsia Self-Screening
POSTPARTUM
BABY
MENTAL WELLNESS
CONTACT
CONTACT US
CATCHMENT AREA
REQUEST A MIDWIFE
LCM NEWS
CLIENT LOGIN
Menu
HOME
HISTORY
MIDWIVES
Administrative Staff
Midwifery Students
CARE
BIRTHPLACE
FAQS
COVID-19
COVID POLICIES
RESOURCES
PREGNANCY
Prenatal Care
Prenatal Education and Support
Pre-eclampsia Self-Screening
POSTPARTUM
BABY
MENTAL WELLNESS
CONTACT
CONTACT US
CATCHMENT AREA
REQUEST A MIDWIFE
LCM NEWS
CLIENT LOGIN
Contact Us
(289) 566 9350
Hours
Mon - Thurs, 9:00 AM to 4:00 PM
Release of Information
Dear:
Fax Number:
I am currently a patient under the care of the midwives at Lincoln Community Midwives. I hereby request that my medical records (as outlined below) be released to Lincoln Community Midwives as soon as possible. The records you can provide will be invaluable. I thank you for your assistance in this matter.
I understand the purpose for disclosing this personal health information to the Lincoln Community Midwives. I understand that I can refuse to sign this consent form.
By filling out this form and clicking on "Submit", I am
Send
