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Client Consent Forms

All signed forms are valid for one year from date of signature, unless otherwise specified. Please contact your caseworker or Lubbock Private Defenders Office with any questions.

Downloadable Forms

Click the icon to open the document for viewing, printing, or downloading.

LPDO's consent packet contains the most common records request forms which permit a designated individual to receive and review medical records on behalf of a patient.

Required by Covenant for any medical records request. 

Required by Social Security Administration to release records regarding legally incompetent adults.

Provide accused's information to the court in support of claimed inability to pay court costs. 

©2026 by Lubbock Private Defenders Office.

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