Submiting forms to your Physician

The Allergy Station

If your student is an Allergy Station patient and you need school, sports, camp, child care, school entry, medication or any other form filled out by an Allergy Station physician, you may be able to fax it in. 
 
In Person:
1528  Eureka  Road,  Suite  102
Roseville,  CA  95661
 
Phone:  (916)  736-­6644
 
Fax: (916)  774-­0143
 
 

Kaiser Permanente - Forms Completion through the Release of Medical Information Department

If your student is a Kaiser Member and you need school, sports, camp, child care, school entry, medication or any other form filled out by a Kaiser Permanente physician, please send it to the Release of Medical Information (ROMI) department.

Email:
General requests: NVLY-MEDSEC-ROI@kp.org
Disability/FMLA: NVLY-MEDSEC-ROI-MISC@kp.org
 
Fax: 877-821-5114

In Person:
(Monday through Friday, 8:30 a.m. to 12:30 p.m. and 1:30 to 5 p.m)
1955 Cowell Boulevard, Davis, CA 95618
2155 Iron Point Road, Folsom, CA 95630
1900 Dresden Drive, Lincoln, CA 95648
10725 International, Rancho Cordova, CA 95670
1001 Riverside Avenue, Junction Building, Roseville, CA 95661
1600 Eureka Road, 2nd Floor, Building D, Roseville, CA 95661 (open during lunch)
2025 Morse Avenue, Sacramento, CA 95825
1650 Response Road, Sacramento, CA 95815 (open during lunch)
 
Please Include:
Child's name
Child's Kaiser medical record number
Parent/Guardian's name
Phone number
Form to be completed (please attach)
Physician’s name
Delivery preference (email, pick up, or mail)


For further information, please contact ROMI at (916) 746-3646