Please provide a signed written authorization for the release of your medical
The form that authorizes
the release of your medical records can be obtained from this website.
Please click on the Patient
Forms page in the navigation bar. Please use the form Revised Authorization For Release of Medical
Fax the form to 805-548-8548 or mail the form to Karen E. Goodrich, M.D.,
P.O. Box 162284, Sacramento, CA 95816.