RELEASE OF INFORMATION FORM
FOR YOUR CONVENIENCE, HERE IS A RELEASE OF INFORMATION FORM. PLEASE FILL OUT AND EITHER:
FAX:
POPLAR (406) 768-6160
WOLF POINT (406) 653-6589
OR MAIL TO:
ATTENTION: MEDICAL RECORDS
P.O. BOX 38
POPLAR, MT 59255
OR
ATTENTION: MEDICAL RECORDS
315 KNAPP ST.
WOLF POINT, MT 59201