Medical Records Release

The first step to participate in a Medical Trial is to provide us with the medical records from your attending physician in order for our doctors to review them and see if you qualify safely for the trial.

If you are interested, please fill out the following form :











    Signature (please draw your signature below)

    I, hereby, give authorize by way of electronic signature to release all medical records as herein described. I authorize Helix Biomedics, LLC to request my medical records from my attending physician.

    Receive a link for discounts on your current medications.