To request a copy of your medical records please complete the Authorization to Release Protected Medical Information. All requests must be in writing, dated, include a reasonable description of the records sought, and be signed by the patient or the patient’s legal guardian. To have your medical records sent to an individual beyond yourself you must include the recipient’s contact information on the Authorization to Release Protect Medical Information for verification purposes.
“There is a reasonable fee consisting of $0.50 per page for the first 50 pages, $0.25 for each additional page, a flat fee of $10.00, plus any postage costs if you request that the copies be mailed. This fee is due in advance of the medical records being released. Requests for medical records can take up to two weeks to complete. If you require your medical records before the two week time frame, we will attempt to accommodate your need, but cannot offer any guarantees.