Request Medical Records

Your medical records can be obtained by coming in to one of our office locations and completing a request form. Alternatively you may obtain your records by downloading a release form from our web site and faxing it to either office location.

Please allow at least 7 days to process your request.

The following information o the form is required to process your request. By not completing all the information, it can delay your request.

• First & Last Name
• Date of Birth
• Current Contact Phone #(s)
• What year treatment was received
• Name of the hpyisican you saw
• Are records for personal use, continuing care or legal (attorney, Short Term Disablity, etc.)

If records need to be sent to another physician, please provide:

• Physician's First & Last Name
• Mailing Address
• Phone #
• Fax #

If you have any questions, give us a call.
(623) 584-5626

• Medical Records Release Authorization