Pediatric HealthCare Associates, P.A.
Facility: Pediatric Healthcare Associates, P.A. Address: 3701 Eldorado Parkway Suite A City: McKinney State: TX, 75070 Phone: 972-548-7888 Fax: 972-562-1170
As the guardian of the patient named below, I give permission to release all medical, mental, and social information to the facility listed. I understand that this information is confidential and will only be used for the benefit of the patient. I further understand that this release is valid for one year or until I revoke the authorization in writing.
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