I hereby authorize and direct The Family Doctors physicians together with associates and assistants of their choice to administer or perform medical treatment on the patient identified, including any additional procedures/services as they deem necessary or reasonable, including but not limited to the administration of injections, x-ray or other radiological and laboratory services. I also hereby authorize the release of medical records to referring physicians and to my insurance companies for the purpose of payment, treatment and healthcare operations. This authorization for consent to medical treatment or surgical procedures is and shall remain valid until revoked.