Medical Release Forms

 

Tift Regional Health System, Inc.

Please use the following form for Tift Regional Health System, Inc. locations:

TRHS Medical Release

For a list of locations, please click this link:

TRHS Locations

 

Southwell Ambulatory, Inc.  

Please use the following form for Southwell Ambulatory, Inc. locations:

Southwell Ambulatory Medical Release

For a list of locations, please click this link:

Southwell Ambulatory Locations

WE LOOK FORWARD TO SERVING YOU

(229) 382-7120 or (800) 648-1935

info@mysouthwell.com

901 18th Street Tifton, GA 31794