You can fill out our forms online or via PDF. Follow the links below to your choice. 

For PDF forms, download it to your computer, and then email the completed form to info@scandocimaging.com OR fax it to 714-424-9594.

DOCUMENT SCANNING ARCHIVING QUOTE REQUEST

ATTORNEY REQUEST FOR RECORDS

AUTHORIZATION FOR USE AND/OR DISCLOSURE OF MEDICAL INFORMATION

AUTHORIZATION TO COPY MEDICAL RECORDS (HIPPA COMPLIANT)

RECORDS REQUEST (NON-ATTORNEY)

WCIRB Request