Forms & Authorizations
These are our forms available for you to download.
They are in PDF format and require Adobe Acrobat Reader, which you can download here for free.
Record Request Form
- Online Record Request Form
- PDF Format - Complete and Email to recordrequest@mm.services
Copy Request Form
PDF Format - Print and Fax
Authorizations
Please email completed authorizations to auths@mm.services.
General Authorizations:
- General Court Authorization
- Release of Cell Phone Records
- Release of Employment Information
- Release of Medical Information
- Release of Pharmacy Records
- Release of Insurance Information
- Release of Educational Records
- College/University Records Release
- Release of Financial Institution Records
- Release of Psychological Records
- Release of Social Service Information
- Release of Substance Abuse & Counseling Information
- Release of Worker's Compensation Records
Our Most Popular Facilities
| Description | Original Signature | Notarization Required | Download Link |
| AT&T | Download Now | ||
| AFLAC | Download Now | ||
| BCBS of Michigan (Member) | Download Now | ||
| BCBS of Michigan (Representative) | Download Now | ||
| Detroit Fire Department EMS | Yes | Download Now | |
| Henry Ford Heath System | Download Now | ||
| Humana | Download Now | ||
| Kroger Pharmacy | Download Now | ||
| Livingston County EMS | Download Now | ||
| Mayo Clinic | Download Now | ||
| Medicare Part A & B | Download Now | ||
| Michigan Department of Community Health (MDCH) | Download Now | ||
| Michigan Department of Treasury | Download Now | ||
| Mobile Medical Response | Yes | Download Now | |
| Molina Healthcare | Download Now | ||
| National Personnel Military Records | Download Now | ||
| Redford Twp. Fire Dept-EMS | Download Now | ||
| Social Security Administration | Download Now | ||
| Social Security Administration (Div. of Earnings) | Download Now | ||
| Traverse City Fire EMS Dept | Yes | Download Now | |
| U of M Hospital | Download Now | ||
| US Dept of Treasury (Form 4506 IRS Tax Return) | Download Now | ||
| VA Hospital - Dept. of Veterans Affairs | Download Now | ||
| Walmart | Download Now |
