Patient record request

For patients requesting that their records be released to a 3rd party:

Complete the Release of Information and the Consent To Communicate documents located in the FORMS section of this page, attach both documents to the message box on the left. Please include your name, DOB, phone#, mailing address, and e-mail address in the message.

Please note that we do not fax records.

For patients requesting their personal records:

Complete the Consent To Communicate document located in the FORMS section of this page and attach the document to the message box on the left. Please include your name, DOB, phone#, mailing address, and e-mail address in the message.

Patient record request

For patients requesting that their records be released to a 3rd party:

For patients requesting their personal records:

FORMS

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