asap4

To Place an order, you may:

  • Simply fill out the form and submit
  • Fax the order to 209-236-1774
  • Need to speak to someone? Call 209-568-4714
  • Email asapcopyservice@ymail.com
  • Mail completed form to:

A.S.A.P Copy Service
211 McHenry Ave Ste B
Modesto, Ca 95354

 ASAP Request Form

OTHER AUTHORIZATIONS YOU MAY NEED:

EMANUEL MEDICAL AUTHORIZATION 
GENERAL HIPAA AUTHORIZATION
KAISER PERMANENTE AUTHORIZATION
MERCY MEDICAL DIGNITY HEALTH AUTHORIZATION
ST JOSEPHS MEDICAL AUTHORIZATION
SUTTER HEALTH AUTHORIZATION