A two-way release of information form allows us and the other party to both share and receive a patient’s confidential information. This form ensures HIPAA compliance while allowing necessary information sharing for care coordination or other purposes. Upon request from a staff member at Centre Pediatrics, please complete this form and read it to its entirety. You can upload the form to Patient Gateway by attaching the PDF in a message to your provider.
617.735.8585
CentrePediatrics@partners.org
