CLIENT FORMS
Click on any of the links below to view or print our client forms
RESOURCES
CLIENT FORMS
CLIENT AUTHORIZATION FORM
Used to add new users to your storage account – must be signed by an authorizing agent
ELECTRONIC RECEIPT (ERECEIPT)
Form used to request an emailed receipt for storage services
ONLINE INVENTORY ACCESS FORM
Request a username and password for the inventory management portal with this form
(For United States locations)
E-SIGNATURE SOFTWARE CONSENT
Form to authorize users to provide signatures via e-signature software
NEWSPAPER ORDER FORM
RECORDS TRANSMITTAL FORMS
Forms to list items sent to the storage facility
HAYS – RECORDS TRANSMITTAL FORM
HUTCHINSON – RECORDS TRANSMITTAL FORM
KANSAS CITY – RECORDS TRANSMITTAL FORM
LOS ANGELES – RECORDS TRANSMITTAL FORM
LOUISVILLE – RECORDS TRANSMITTAL FORM
MANHATTAN – RECORDS TRANSMITTAL FORM
OKLAHOMA CITY – RECORDS TRANSMITTAL FORM
TOPEKA – RECORDS TRANSMITTAL FORM
WICHITA – RECORDS TRANSMITTAL FORM
HIPPA AUTHORIZATION FORM
Patients requesting records from their doctor’s storage account – select form where records are located
HUTCHINSON STORAGE FACILITY
KANSAS CITY STORAGE FACILITY
LOUISVILLE STORAGE FACILITY
OKLAHOMA CITY STORAGE FACILITY
WICHITA STORAGE FACILITY
Have questions on storage procedures, click here to contact customer service, or check out our other storage services.
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