Release of Information Form

After downloading and completing the Release of Information Form below you must submit the completed form to our office by:
  1. Deliver the completed form in person to the
  2. office Fax the completed form to (972) 985-7499
  3. Mail the completed form to the office

Office Address:

Dr. Jawad Riaz
935 W. Exchange PKWY, Ste 110,
Allen, TX 75013