Authorization Forms

Click the specific links to access the desired form.

HIPAA Compliant Patient Authorization

Employment Payroll Authorization

Medicare Authorization Form

Texas Medicaid Authorization - Form 6700

Tax Return Authorization Form 4506

(*Note: Written Deposition Service, LLC will no longer submit these requests.  The IRS rarely provides responsive records to third parties, yet they require substantial prepayments, which may or may not be refunded.)

Texas Department of Family and Protective Services

Military Records - Standard Form 180

Social Security Earnings - Form SSA-7050-F4

Texas Workforce Commission Authorization

Social Security Disability Records
(This governmental entity requires their specific authorization to be dated within 60 days)

Texas Department of Insurance - Division of Worker's Comp - Form 153

(*Note: Law firms must submit requests directly to the Texas Department of Insurance. They do not accept requests from third parties.)