How do you cite or reference a document that you have obtained from a facility at the end of your table? I received a document from Amarillo Diagnostic Clinic (the facility name), the title of the document is Employee Benefits Choice Form and the revision date is January 2012. I used a table off of this form, so at the end of the table I put
"From Employee Benefits Choice Form. (2012). Amarillo Diagnostic Clinic." Is this correct?

Question

How do you cite or reference a document that you have obtained from a facility at the end of your table? I received a document from Amarillo Diagnostic Clinic (the facility name), the title of the document is Employee Benefits Choice Form and the revision date is January 2012.  I used a table off of this form, so at the end of the table I put
"From Employee Benefits Choice Form. (2012). Amarillo Diagnostic Clinic." Is this correct?