Release Authorization Forms
Please download and fill out the appropriate release authorization form from below to authorize the release of your medical information to Dr.Tondapu.
Former USMD patients should fill, sign and fax the Release authorization form to 817-514-7879.
General Release Authorization form for patients coming to Flower Mound office
Release Authorization form for former USMD patients coming to Flower Mound Office
General Release Authorization form for patients coming to Fort Worth office
Release Authorization form for former USMD patients coming to Fort Worth Office
Please send us the completed copy as soon as possible so we can get your records before your appointment. You can fax the completed form to 877-776-3240.