Medical Records Request

Medical Record Request

Patient Name
Is the patient a minor or under guardianship?
If Yes, Name of Parent/ Guardian
Notes (In Order):
  • Please allow 7–10 business days for this request to be processed.

  • A staff member will call you when your records are ready to be released.

  • The patient or guardian is responsible for picking up records and signing a release.

  • Medical records are pick-up only.
    → They will not be faxed or emailed.