PATIENT SERVICES OCB Optical Make an Appointment Order Contacts Refill Prescriptions Change Patient Info Info by Mail New Patient Registration Patient Satisfaction Homepage Medical Records Release Authorization Fill out the following information to create a printable release form. Patient Name: (First, Middle, Last)     Date of Birth: I hereby authorize my medical records be released to: Ophthalmic Consultants of Boston (OCB) 50 Staniford Street, Suite 600 Boston, MA 02114 (617) 3674800 Fax: (617) 723-7028 I hereby authorize Ophthalmic Consultants of Boston (OCB) to release my medical records to: Doctor's Name: Address: City/State/Zip:

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