Forms & Authorizations

These are our forms available for you to download.
They are in PDF format and require Adobe Acrobat Reader, which you can download here for free.

Record Request Form

Copy Request Form

PDF Format - Print and Fax

Authorizations

Please email completed authorizations to auths@mm.services.

General Authorizations:

Our Most Popular Facilities

Description Original Signature Notarization Required Download Link
AFLAC     Download Now
BCBS of Michigan (Member)     Download Now
BCBS of Michigan (Representative)     Download Now
Detroit Fire Department EMS   Yes Download Now
Henry Ford Heath System     Download Now
Kroger Pharmacy     Download Now
Life EMS     Download Now
Livingston County EMS     Download Now
Mayo Clinic     Download Now
Medicare Part A & B     Download Now
Michigan Department of Community Health (MDCH)     Download Now
Michigan Department of Treasury     Download Now
Mobile Medical Response   Yes Download Now
Molina Healthcare     Download Now
Redford Twp. Fire Dept-EMS     Download Now
Social Security Administration     Download Now
Social Security Administration (Div. of Earnings)     Download Now
Traverse City Fire EMS Dept   Yes Download Now
U of M Hospital     Download Now
US Dept of Treasury (Form 4506 IRS Tax Return)     Download Now
VA Hospital - Dept. of Veterans Affairs     Download Now
Walmart     Download Now

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