Dental Record Release Forms from Clearwater Dental
If you would like to authorize us to release your dental records from Clearwater Dental to another practice, you have the option submit the request on our website below, or print out the PDF form to fill out. You may bring them into the office or mail them to our address at: Clearwater Dental, 5000 W Clearwater Ave, Kennewick, WA 99336.
Authorization to release my information
I authorize Clearwater Dental to release the following dental information to the dentist or healthcare provider below. This includes all health care information, current full mouth, panoramic, bitewing x-rays and perio charting.