Home » Current Patients » Medical Records Request

Medical Records Request

If you need a copy of your child’s medical records, please complete the Medical Records Request form. This is required before any information can be released to you. The form must be signed by a custodial/legal guardian.

In order to cover the administrative costs of providing you with a copy of your child’s medical records, a fee of $25.00 will be charged regardless of method of distribution.

No medical records will be faxed. You may pick up the records at the office when ready or the records can be forwarded to another provider.