Authorization for Release of Information FROM Lincoln University

To have Lincoln University Student Health Center release your medical records, please open printer-friendly version of document, print, complete, and submit to our office.  Forms may be submitted in person to Thompkins Center; by fax to (573) 681-5877; or by mail to Lincoln University Student Health Center, 822 Lee Drive, Jefferson City, MO 65101.

 

 

 

 

 

 Authorization for Release of Information TO Lincoln University

To have your medical information released to Lincoln University Student Health Center, please open printer-friendly version of document, print, complete and submit to agency you are requesting information from.