Record Services 

SERVING THE LEGAL AND CORPORATE COMMUNITIES FOR OVER 57 YEARS


EXPERIENCE • QUALITY • DEPENDABILITY

IL 312.726.6650  •  MI 734.591.4100  •  PA 215.241.5858

FORMS - PENNSYLVANIA

Our request forms are available in three formats:
Acrobat® (PDF) - Word® (DOC) - Wordperfect® (WPD).

After selecting a form you can choose:
"Open" to load the form and fill it out or
"Save" to download the file to your computer.

PDF DOC WPD  Multi Record Request
PDF DOC WPD  Multi Record Request with Deponent Rider
PDF DOC WPD  HIPAA Authorization
PDF DOC WPD  HIPAA Authorization - with notary

PDF

DOC WPD  Request For Copying/Printing
PDF DOC WPD  Help Note

AUTHORIZATION FORMS (PDF Format)

Academic Records
Employment Records

IRS - Form 4506
Mayo Clinic
Medicare
Military HIPAA
National Personnel Record Center (NPRC)
Social Security Administration (SSA)
Veterans Affairs
Walgreens

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