Release Forms
Credit Card Authorization
This form authorizes the secure processing of your credit card payment for specified transactions.
Credit Card Authorization Form Staff Time Off Request
Submit a request for vacation, sick leave, or personal time. Your manager will review and approve or deny the request.
Time Off Request X-Ray Release & Request Form
This form authorizes the release of Patient X-ray images and related records to designated recipients and allows Patients to request additional X-ray examinations as needed.
To GWD from Another Facility From GWD to Another Facility