{"id":4015,"date":"2025-01-03T12:54:23","date_gmt":"2025-01-03T17:54:23","guid":{"rendered":"https:\/\/nweyeclinic.com\/?page_id=4015"},"modified":"2025-01-03T12:54:24","modified_gmt":"2025-01-03T17:54:24","slug":"patient-form","status":"publish","type":"page","link":"https:\/\/nweyeclinic.com\/so\/patient-form\/","title":{"rendered":"Foomamka Bukaanka"},"content":{"rendered":"

For your convenience, below you will find a printable (and form-fillable) Medical Records Release.<\/p>\n\n\n\n

To have your medical records released from Northwest Eye, please download the PDF, complete the form electronically, then email it to roi@nweyeclinic.com<\/a>. You may also download and print the document, complete it, and fax it to (952) 473-4218<\/a>.<\/p>\n\n\n\n

Should you need any additional information or help, please contact us<\/a>.<\/p>\n\n\n

\n
\"\"<\/a>
Download Medical Records Request<\/figcaption><\/figure>\n<\/div>","protected":false},"excerpt":{"rendered":"

For your convenience, below you will find a printable (and form-fillable) Medical Records Release. To have your medical records released from Northwest Eye, please download the PDF, complete the form electronically, then email it to roi@nweyeclinic.com. You may also download and print the document, complete it, and fax it to (952) 473-4218. Should you need… Akhriso wax dheeraad ah<\/a><\/p>","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","footnotes":""},"tags":[69],"class_list":["post-4015","page","type-page","status-publish","hentry","tag-patient-form"],"acf":[],"yoast_head":"\nDownload Your Medical Records Here | Northwest Eye Care<\/title>\n<meta name=\"description\" content=\"Quickly and easily download and submit your medical records release form at Northwest Eye Care.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/nweyeclinic.com\/so\/patient-form\/\" \/>\n<meta property=\"og:locale\" content=\"so_SO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Download Your Medical Records Here | Northwest Eye Care\" \/>\n<meta property=\"og:description\" content=\"Quickly and easily download and submit your medical records release form at Northwest Eye Care.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/nweyeclinic.com\/so\/patient-form\/\" \/>\n<meta property=\"og:site_name\" content=\"Northwest Eye\" \/>\n<meta property=\"article:modified_time\" content=\"2025-01-03T17:54:24+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/\"},\"author\":{\"name\":\"becky.lowe@uvpeye.com\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#\\\/schema\\\/person\\\/9ab74212f0c48f16fd3af13ca7a89f3f\"},\"headline\":\"Patient Forms\",\"datePublished\":\"2025-01-03T17:54:23+00:00\",\"dateModified\":\"2025-01-03T17:54:24+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/\"},\"wordCount\":70,\"publisher\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/nweyeclinic.com\\\/wp-content\\\/uploads\\\/Patient-Portal.png\",\"keywords\":[\"patient form\"],\"inLanguage\":\"so\"},{\"@type\":[\"WebPage\",\"MedicalWebPage\"],\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/\",\"url\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/\",\"name\":\"Download Your Medical Records Here | Northwest Eye Care\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/nweyeclinic.com\\\/wp-content\\\/uploads\\\/Patient-Portal.png\",\"datePublished\":\"2025-01-03T17:54:23+00:00\",\"dateModified\":\"2025-01-03T17:54:24+00:00\",\"description\":\"Quickly and easily download and submit your medical records release form at Northwest Eye Care.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#breadcrumb\"},\"inLanguage\":\"so\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"so\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#primaryimage\",\"url\":\"https:\\\/\\\/nweyeclinic.com\\\/wp-content\\\/uploads\\\/Patient-Portal.png\",\"contentUrl\":\"https:\\\/\\\/nweyeclinic.com\\\/wp-content\\\/uploads\\\/Patient-Portal.png\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/patient-form\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/nweyeclinic.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Patient Forms\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#website\",\"url\":\"https:\\\/\\\/nweyeclinic.com\\\/\",\"name\":\"Northwest Eye\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/nweyeclinic.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"so\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#organization\",\"name\":\"Northwest Eye\",\"url\":\"https:\\\/\\\/nweyeclinic.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"so\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/nweyeclinic.com\\\/wp-content\\\/uploads\\\/NWE_LogoTAG_Horz-p-500.png\",\"contentUrl\":\"https:\\\/\\\/nweyeclinic.com\\\/wp-content\\\/uploads\\\/NWE_LogoTAG_Horz-p-500.png\",\"width\":500,\"height\":123,\"caption\":\"Northwest Eye\"},\"image\":{\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/nweyeclinic.com\\\/#\\\/schema\\\/person\\\/9ab74212f0c48f16fd3af13ca7a89f3f\",\"name\":\"becky.lowe@uvpeye.com\",\"url\":\"https:\\\/\\\/nweyeclinic.com\\\/so\\\/author\\\/becky-loweuvpeye-com\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Download Your Medical Records Here | Northwest Eye Care","description":"Quickly and easily download and submit your medical records release form at Northwest Eye Care.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/nweyeclinic.com\/so\/patient-form\/","og_locale":"so_SO","og_type":"article","og_title":"Download Your Medical Records Here | Northwest Eye Care","og_description":"Quickly and easily download and submit your medical records release form at Northwest Eye Care.","og_url":"https:\/\/nweyeclinic.com\/so\/patient-form\/","og_site_name":"Northwest Eye","article_modified_time":"2025-01-03T17:54:24+00:00","twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/nweyeclinic.com\/patient-form\/#article","isPartOf":{"@id":"https:\/\/nweyeclinic.com\/patient-form\/"},"author":{"name":"becky.lowe@uvpeye.com","@id":"https:\/\/nweyeclinic.com\/#\/schema\/person\/9ab74212f0c48f16fd3af13ca7a89f3f"},"headline":"Patient Forms","datePublished":"2025-01-03T17:54:23+00:00","dateModified":"2025-01-03T17:54:24+00:00","mainEntityOfPage":{"@id":"https:\/\/nweyeclinic.com\/patient-form\/"},"wordCount":70,"publisher":{"@id":"https:\/\/nweyeclinic.com\/#organization"},"image":{"@id":"https:\/\/nweyeclinic.com\/patient-form\/#primaryimage"},"thumbnailUrl":"https:\/\/nweyeclinic.com\/wp-content\/uploads\/Patient-Portal.png","keywords":["patient form"],"inLanguage":"so"},{"@type":["WebPage","MedicalWebPage"],"@id":"https:\/\/nweyeclinic.com\/patient-form\/","url":"https:\/\/nweyeclinic.com\/patient-form\/","name":"Download Your Medical Records Here | Northwest Eye Care","isPartOf":{"@id":"https:\/\/nweyeclinic.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/nweyeclinic.com\/patient-form\/#primaryimage"},"image":{"@id":"https:\/\/nweyeclinic.com\/patient-form\/#primaryimage"},"thumbnailUrl":"https:\/\/nweyeclinic.com\/wp-content\/uploads\/Patient-Portal.png","datePublished":"2025-01-03T17:54:23+00:00","dateModified":"2025-01-03T17:54:24+00:00","description":"Quickly and easily download and submit your medical records release form at Northwest Eye Care.","breadcrumb":{"@id":"https:\/\/nweyeclinic.com\/patient-form\/#breadcrumb"},"inLanguage":"so","potentialAction":[{"@type":"ReadAction","target":["https:\/\/nweyeclinic.com\/patient-form\/"]}]},{"@type":"ImageObject","inLanguage":"so","@id":"https:\/\/nweyeclinic.com\/patient-form\/#primaryimage","url":"https:\/\/nweyeclinic.com\/wp-content\/uploads\/Patient-Portal.png","contentUrl":"https:\/\/nweyeclinic.com\/wp-content\/uploads\/Patient-Portal.png"},{"@type":"BreadcrumbList","@id":"https:\/\/nweyeclinic.com\/patient-form\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/nweyeclinic.com\/"},{"@type":"ListItem","position":2,"name":"Patient Forms"}]},{"@type":"WebSite","@id":"https:\/\/nweyeclinic.com\/#website","url":"https:\/\/nweyeclinic.com\/","name":"Northwest Eye","description":"","publisher":{"@id":"https:\/\/nweyeclinic.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/nweyeclinic.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"so"},{"@type":"Organization","@id":"https:\/\/nweyeclinic.com\/#organization","name":"Northwest Eye","url":"https:\/\/nweyeclinic.com\/","logo":{"@type":"ImageObject","inLanguage":"so","@id":"https:\/\/nweyeclinic.com\/#\/schema\/logo\/image\/","url":"https:\/\/nweyeclinic.com\/wp-content\/uploads\/NWE_LogoTAG_Horz-p-500.png","contentUrl":"https:\/\/nweyeclinic.com\/wp-content\/uploads\/NWE_LogoTAG_Horz-p-500.png","width":500,"height":123,"caption":"Northwest Eye"},"image":{"@id":"https:\/\/nweyeclinic.com\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/nweyeclinic.com\/#\/schema\/person\/9ab74212f0c48f16fd3af13ca7a89f3f","name":"becky.lowe@uvpeye.com","url":"https:\/\/nweyeclinic.com\/so\/author\/becky-loweuvpeye-com\/"}]}},"taxonomy_info":{"post_tag":[{"value":69,"label":"patient form"}]},"featured_image_src_large":false,"author_info":{"display_name":"becky.lowe@uvpeye.com","author_link":"https:\/\/nweyeclinic.com\/so\/author\/becky-loweuvpeye-com\/"},"comment_info":"","_links":{"self":[{"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/pages\/4015","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/comments?post=4015"}],"version-history":[{"count":1,"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/pages\/4015\/revisions"}],"predecessor-version":[{"id":4018,"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/pages\/4015\/revisions\/4018"}],"wp:attachment":[{"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/media?parent=4015"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nweyeclinic.com\/so\/wp-json\/wp\/v2\/tags?post=4015"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}