RMC

Patient Documents

Patient Documents

Medical Records Requests

For medical records to Riverside Medical Clinic from another healthcare provider: In order for another healthcare provider to forward your medical records to us, they will need a medical records release form completed and submitted to them. You can download the form here.

Click here to download form

For medical records from Riverside Medical Clinic to another healthcare provider: In order for us to release your medical records to another healthcare provider, we will need a medical records release form completed and submitted to us. You can download the form here.

Click here to download form

“Third Party Consents for Minors”  This form is completed and returned by a parent or guardian to give consent to a caregiver to seek medical care for a minor child.  You can download the form here.

Click here to download form

Staying Healthy Assessment Forms

As per MMCD Policy Letter 13-001, Staying Healthy Assessment (SHA) forms must be administered to new patients during the Initial Health Assessment (IHA) and periodically thereafter as the patient enters a new age category. SHA forms may be downloaded and printed in multiple age categories and languages below or from the DHCS website. http://www.dhcs.ca.gov/formsandpubs/forms/Pages/StayingHealthy.aspx