REQUIRED DOCUMENTATION FOR MEDICAL RECORDS

A Medical Records Request Form is required when you are requesting copies of medical records or asking that we disclose your health information to any third-parties.

The  Medical Records Request Form is not valid if one or more required elements are left blank.  Failure to complete all required elements may result in a delay in processing your request.  All request, whether delivered in person, by mail, or via fax, require 7-10 business days to process.

No same day requests will be accepted.

Digital Form Option