Electronic Record Request

  • Please provide area code and extension if applicable
  • ie: Lab Results for the last 6 months; CT scans from Month/Year; or Surgical Notes from appendectomy on (date)
    Your privacy is one of our top priorities. Once we receive this request we will be in touch to verify the owner of the information is making the request.
  • Before sending any medical records we will use this information to verify the request. Be sure to list any necessary extensions or name information that may be helpful.
  • Please allow up to a 6 week processing period for all Medical Record Requests.