51³Ô¹ÏÍø

Forms and Documents

Parent/Guardian Forms

Required for patients under the age of 18.

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Patient Forms

To have your medical records sent to 51³Ô¹ÏÍø or released by 51³Ô¹ÏÍø, please complete this form. Allow up to 2 weeks for processing.

If SHS has referred you to Mantra Health, please complete this form.

Designation of a Health Care Surrogate

If you wish to designate a health care surrogate, please print and complete this form.

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Feedback and Complaints

You may use the Feedback and Complaints form for:

• Compliments
• Suggestions
• Reporting a Negative Experience at SHS
• Requesting Corrective Actions from SHS