Authorization for Release of Information Form


 

Download a Release of Information Form, print a copy, fill it out, and fax it or send to the appropriate contact address below.

Fax: 716-832-3282 (Amherst) 716-262-0631 (Cheektowaga)

The addresses for mailing these requests are as follows:

3488 Sheridan Drive, Amherst , NY 14226

2865 Genesee Street, Cheektowaga, NY 14225

Our Locations

Choose your preferred location